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=Volume 14 - 2023

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=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 µg/ml, 22.57 µg/ml, 0.22 µg/ml, 0.61 µg/ml 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.