AUTHOR=Takei Sella , Kinoshita Hiroshi , Jamal Mostofa , Kumihashi Mitsuru , Yamashita Tadayoshi , Tanaka Etsuko , Kawahara Sachiko , Abe Hiroko , Tsutsui Kunihiko , Kimura Shoji 

TITLE=Case report: Fatal poisoning caused by additive effects of two barbiturates

JOURNAL=Frontiers in Pharmacology

VOLUME=14

YEAR=2023

URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2023.1196565

DOI=10.3389/fphar.2023.1196565

ISSN=1663-9812

ABSTRACT=<p>A case of fatal poisoning involving multiple psychotropic drugs is presented. Quantitative toxicological analysis showed femoral blood concentrations of pentobarbital, phenobarbital, duloxetine, acetaminophen and tramadol were 10.39, 22.57, 0.22, 0.61 and 0.22 μg/ml, respectively. We concluded that the death was due to the additive effects of two barbiturates. As both pentobarbital and phenobarbital act on gamma-aminobutyric acid (GABA) receptors, central nervous system activity was suppressed, causing respiratory depression. Additive pharmacological effects should be considered in cases of massive ingestion of multiple drugs.</p>