Abstract
We report fatal cases of cyclobarbital poisoning. A Japanese husband and wife, 89 and 91 years old, respectively, were found dead in their locked home. The postmortem blood concentrations of cyclobarbital in the husband (68 μg/ml) and wife (70 μg/ml) were measured by gas chromatography–mass spectrometry and clearly exceeded the therapeutic range. In the absence of other remarkable autopsy findings, the deaths in these two cases were determined to be caused by cyclobarbital poisoning, which is extremely rare. Despite its current unavailability, cyclobarbital was shown to be the cause of death, emphasizing the importance of toxicological screening for cyclobarbital.
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References
Sørensen LK (2011) Determination of acidic and neutral therapeutic drugs in human blood by liquid chromatography–electrospray tandem mass spectrometry. Forensic Sci Int 206:119–126
Kwan P, Brodie MJ (2004) Phenobarbital for the treatment of epilepsy in the 21st century: a critical review. Epilepsia 45:1141–1149
Tanaka E, Terada M, Tanno K, Misawa S, Wakasugi C (1997) Forensic analysis of 10 barbiturates in human biological samples using a new reversed-phase chromatographic column packed with 2-micrometre porous microspherical silica-gel. Forensic Sci Int 85:73–82
Roberts JR, Tafuri JA (1990) Barbiturates, methaqualone and primidone. In: Haddad LM, Winchester JF (eds) Clinical management of poisoning and drug overdose, 2nd edn. W. B. Saunders, Philadelphia, pp 718–730
Lee X-P, Kumazawa T, Hasegawa C, Arinobu T, Seno H, Suzuki O, Sato K (2013) High-throughput determination of barbiturates in human plasma using on-line column-switching ultra-fast liquid chromatography–tandem mass spectrometry. Forensic Toxicol 31:9–20
Menck RA, de Oliveira CDR, de Lima DS, Goes LE, Leyton V, Pasqualucci CA, Muñoz DR, Yonamine M (2013) Hollow fiber–liquid phase microextraction of barbiturates in liver samples. Forensic Toxicol 31:31–36
Regenthal R, Krueger M, Koeppel C, Preiss R (1999) Drug levels: therapeutic and toxic serum/plasma concentrations of common drugs. J Clin Monit Comput 15:529–544
Winek CL, Wahba WW, Winek CL Jr, Balzer TW (2001) Drug and chemical blood-level data 2001. Forensic Sci Int 122:107–123
Musshoff F, Padosch S, Steinborn S, Madea B (2004) Fatal blood and tissue concentrations of more than 200 drugs. Forensic Sci Int 142:161–210
Brodie MJ, Dichter MA (1996) Antiepileptic drugs. N Engl J Med 334:168–175
French J (1994) The long-term therapeutic management of epilepsy. Ann Intern Med 120:411–422
Gilman JT, Gal P (1992) Pharmacokinetic and pharmacodynamic data collection in children and neonates. A quiet frontier. Clin Pharmacokinet 23:1–9
Koniaris LG, Zimmers TA, Lubarsky DA, Sheldon JP (2005) Inadequate anaesthesia in lethal injection for execution. Lancet 365:1412–1414
Schulz M, Iwersen-Bergmann S, Andresen H, Schmoldt A (2012) Therapeutic and toxic blood concentrations of nearly 1,000 drugs and other xenobiotics. Crit Care 16:R136
Breimer DD, Winten MA (1976) Pharmacokinetics and relative bioavailability of cyclobarbital calcium in man after oral administration. Eur J Clin Pharmacol 9:443–450
Kudo K, Ishida T, Hara K, Kashimura S, Tsuji A, Ikeda N (2007) Simultaneous determination of 13 amphetamine related drugs in human whole blood using an enhanced polymer column and gas chromatography–mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci 855:115–120
Janke W, Schmatzer E (1962) Experimental psychologische Untersuchungen zur Wirkung einer Prothipendyl-Cyclobarbital-Calcium-Kombination im Vergleich zu Cyclobarbital-Calcium und Placebo. Arzneimittel Forsch 12:1031–1036
Yarema MC, Becker CE (2005) Key concepts in postmortem drug redistribution. Clin Toxicol (Phila) 43:235–241
Pélissier-Alicot AL, Gaulier JM, Champsaur P, Marquet P (2003) Mechanisms underlying postmortem redistribution of drugs: a review. J Anal Toxicol 27:533–544
Miller LG, Deutsch SI, Greenblatt DJ, Paul SM, Shader RI (1988) Acute barbiturate administration increases benzodiazepine receptor binding in vivo. Psychopharmacology 96:385–390
Güven M, Unlühizarci K, Goktas Z, Kurtoğlu S (1997) Intravenous organophosphate injection: an unusual way of intoxication. Hum Exp Toxicol 16:279–280
Buchman MT (2000) Upper extremity injection of household insecticide: a report of five cases. J Hand Surg [Am] 25:764–767
Nishioka SA (1994) Parenteral injection of organophosphate insecticide. Apropos of two cases. Sao Paulo Med J 112:561–563
Zoppellari R, Borron SW, Chieregato A, Targa L, Scaroni I, Zatelli R (1997) Isofenphos poisoning: prolonged intoxication after intramuscular injection. J Toxicol Clin Toxicol 35:401–404
Fourtes LJ, Ayebo AD, Kross BC (1993) Cholinesterase-inhibiting insecticide toxicity. Am Fam Physician 47:1613–1620
Yurumez Y, Durukan P, Yavuz Y, Ikizceli I, Avsarogullari L, Ozkan S, Akdur O, Ozdemir C (2007) Acute organophosphate poisonings in university hospital emergency room patients. Internal Med 46:965–969
Premaratna R, Tilakarathna Y, Fonseka MM, Gunatilake SB, de Silva HJ (2001) Parasuicide by self-injection of an organophosphate insecticide. Hum Exp Toxicol 20:377–378
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Torimitsu, S., Yajima, D., Abe, H. et al. Homicide–suicide by oral administration of cyclobarbital. Forensic Toxicol 32, 180–185 (2014). https://doi.org/10.1007/s11419-013-0211-8
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DOI: https://doi.org/10.1007/s11419-013-0211-8