title: Pentobarbital in the context of possible suicides: Analysis of a Case.
abstract: Pentobarbital is a barbiturate, acting as a central nervous system depressant (CNS), being used for its anticonvulsant, sedative, hypnotic and anaesthetic properties. Barbiturates were replaced by benzodiazepines, leading to a decrease in poisoning cases with these compounds. However, pentobarbital is still used in many countries as an anaesthetic in veterinary medicine. Due to its properties, this compound is sought after by people who wish to commit suicide, acquiring it on the black market. The authors present an unusual fatal pentobarbital intoxication case, in a 37 years-old male salesperson, with no known connection with the veterinary field, being more difficult to obtain this compound. Toxicological results in cardiac blood revealed the presence of pentobarbital (111mg/L), ethanol (0.94g/L), diazepam (33ng/mL), nordiazepam (50ng/mL), oxazepam (3.3ng/mL), temazepam (5.3ng/mL), and metoclopramide. No illicit drugs were detected. Pentobarbital analysis in urine and gastric content was also positive, as well as its presence in the glass powder and in the bottle residue sent to the laboratory. In the present case, it was possible to conclude that the death was a suicide due to pentobarbital intoxication in association with other depressants of the CNS (benzodiazepines and ethanol). It is important to search pentobarbital in routine toxicological analyses, since it is one of the drugs most frequently mentioned by entities defending "painless death", advising the simultaneous use of metoclopramide for emesis avoidance.
authors.affiliation: National Institute of Legal Medicine and Forensic Sciences, Portugal. Electronic address: paula.l.melo@inmlcf.mj.pt.
authors.forename: Paula
authors.initials: P
authors.lastname: Melo
authors.affiliation: National Institute of Legal Medicine and Forensic Sciences, Portugal. Electronic address: pedro.c.costa@inmlcf.mj.pt.
authors.forename: Pedro
authors.initials: P
authors.lastname: Costa
authors.affiliation: National Institute of Legal Medicine and Forensic Sciences, Portugal. Electronic address: maria.j.quintas@inmlcf.mj.pt.
authors.forename: Maria José
authors.initials: MJ
authors.lastname: Quintas
authors.affiliation: National Institute of Legal Medicine and Forensic Sciences, Portugal. Electronic address: andre.l.castro@inmlcf.mj.pt.
authors.forename: André
authors.initials: A
authors.lastname: Castro
authors.affiliation: National Institute of Legal Medicine and Forensic Sciences, Portugal. Electronic address: sonia.h.tarelho@inmlcf.mj.pt.
authors.forename: Sónia
authors.initials: S
authors.lastname: Tarelho
authors.affiliation: National Institute of Legal Medicine and Forensic Sciences, Portugal. Electronic address: j.miguel.franco@inmlcf.mj.pt.
authors.forename: João Miguel
authors.initials: JM
authors.lastname: Franco
authors.affiliation: National Institute of Legal Medicine and Forensic Sciences, Portugal; Faculty of Medicine, University of Coimbra, Coimbra, Portugal. Electronic address: helena.m.teixeira@inmlcf.mj.pt.
authors.forename: Helena M
authors.initials: HM
authors.lastname: Teixeira
mesh_terms: D000328:Adult; D002492:Central Nervous System Depressants / Q000032:analysis / Q000506:poisoning*; D003975:Diazepam / Q000032:analysis; D000431:Ethanol / Q000032:analysis; D005766:Gastrointestinal Contents / Q000737:chemistry; D006801:Humans; D008297:Male; D003708:Nordazepam / Q000032:analysis; D010076:Oxazepam / Q000032:analysis; D010424:Pentobarbital / Q000032:analysis / Q000506:poisoning*; D013405:Suicide; D013693:Temazepam / Q000032:analysis
chemical_list: D002492:Central Nervous System Depressants; D000431:Ethanol; D003708:Nordazepam; D010076:Oxazepam; D013693:Temazepam; D010424:Pentobarbital; D003975:Diazepam
keywords: Case report; Forensic toxicology; Pentobarbital intoxication