title: Intravenous and oral suicidal e-liquid poisonings with confirmed nicotine and cotinine concentrations.
abstract: The increasing availability of e-cigarettes is a potential toxicological concern. E-cigarettes appeared on the Polish market in 2006, and since 2009 they have been widely available with a new source of nicotine, the so-called e-liquid. In this paper two cases of suicidal oral and intravenous poisonings with the e-liquid are described. The clinical courses of these poisonings are presented. Nicotine and cotinine concentrations in the patient's blood were determined using high performance liquid chromatography with diode array detection. In the course of intoxication patient No. 1, classic symptoms of acute nicotine poisoning without convulsions were observed. Nicotine and cotinine concentrations measured in serum were 0.096 and 4.4mg/L, respectively. The case of patient No. 2, admission with no typical symptoms of nicotine poisoning was identified, except unconsciousness and slow respiration. Nicotine and cotinine concentrations in the serum at the time of No. 2 admissions were determined to be 0.8 and 1.3mg/L, respectively. With the increasing number of e-liquid poisonings cases, it should be aware that these products can be a readily available source of poison.
authors.affiliation: Poznan University of Medical Sciences, Department of Toxicology, Dojazd Street 30, 60-631 Poznan, Poland. Electronic address: karina.sommerfeld@gmail.com.
authors.forename: Karina
authors.initials: K
authors.lastname: Sommerfeld
authors.affiliation: Poznan University of Medical Sciences, Department of Emergency Medicine, Przybyszewskiego Street 49, 60-355 Poznan, Poland; Department of Toxicology, Raszeja Hospital, Mickiewicza Street 30, 60-834 Poznan, Poland. Electronic address: madzikuska@op.pl.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Łukasik-Głębocka
authors.affiliation: Poznan University of Medical Sciences, Department of Toxicology, Laboratory of Environmental Research, Dojazd Street 30, 60-631 Poznan, Poland. Electronic address: fhmmax@gmail.com.
authors.forename: Maksymilian
authors.initials: M
authors.lastname: Kulza
authors.affiliation: University School of Physical Education in Poznan, Department of the Rehabilitation in Internal Disease, Królowej Jadwigi Street 27/39, 61-871 Poznan, Poland. Electronic address: adruzdz@op.pl.
authors.forename: Artur
authors.initials: A
authors.lastname: Drużdż
authors.affiliation: Poznan University of Medical Sciences, Department of Emergency Medicine, Przybyszewskiego Street 49, 60-355 Poznan, Poland. Electronic address: ppanienski@ump.edu.pl.
authors.forename: Paweł
authors.initials: P
authors.lastname: Panieński
authors.affiliation: Poznan University of Medical Sciences, Department of Toxicology, Laboratory of Environmental Research, Dojazd Street 30, 60-631 Poznan, Poland. Electronic address: ewaflorek@ump.edu.pl.
authors.forename: Ewa
authors.initials: E
authors.lastname: Florek
authors.affiliation: Poznan University of Medical Sciences, Department of Toxicology, Dojazd Street 30, 60-631 Poznan, Poland. Electronic address: bzielin@ump.edu.pl.
authors.forename: Barbara
authors.initials: B
authors.lastname: Zielińska-Psuja
mesh_terms: D000284:Administration, Oral; D000328:Adult; D002851:Chromatography, High Pressure Liquid; D003367:Cotinine / Q000097:blood*; D066300:Electronic Nicotine Delivery Systems; D005260:Female; D005731:Ganglionic Stimulants / Q000008:administration & dosage* / Q000097:blood / Q000506:poisoning; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D009538:Nicotine / Q000008:administration & dosage* / Q000097:blood* / Q000506:poisoning; D013406:Suicide, Attempted; D055815:Young Adult
chemical_list: D005731:Ganglionic Stimulants; D009538:Nicotine; D003367:Cotinine
keywords: Cotinine; E-liquid; Nicotine; Poisoning; Serum concentration