Document Detail

Toxicokinetics of acute strychnine poisoning.
MedLine Citation:
PMID:  9365429     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Strychnine competes with the inhibitory neurotransmitter glycine producing an excitatory state characterized clinically by hyperreflexia, severe muscle spasms, and convulsions. However, the kinetics after overdose have not been well described.
CASE REPORT: A 34 year-old male presented to the emergency department 20 minus after ingesting half of a 250-mL container of 2% strychnine sulfate (2.25 g). The reported lethal dose is 100-120 mg. He was alert and oriented and experiencing muscle spasms. His condition deteriorated prompting sedation, muscle paralysis, and tracheal intubation. He was given activated charcoal 100 g per nasogastric tube. He was admitted to intensive care where he was managed with diazepam, pentobarbital, and pancuronium. Despite mild rhabdomyolysis, he recovered and was extubated on day three. Although receiving prophylactic heparin therapy, a massive fatal pulmonary embolus ensued. Eighteen blood specimens for strychnine analysis were obtained from 20 minutes to 51 hours after ingestion. Serum concentrations were determined with gas chromatography-mass spectroscopy. Disappearance followed a first-order process with a t 1/2 of 16 hours (r, = 0.97).
DISCUSSION: Our results confirm the findings of an earlier case report of 19 strychnine levels obtained between 4 and 19 hours which described first-order kinetics with a similar t 1/2 of 10 hours.
CONCLUSION: Strychnine disappearance in this overdose was well described by a first-order process with a t 1/2 of 10-16 hours.
W Palatnick; R Meatherall; D Sitar; M Tenenbein
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of toxicology. Clinical toxicology     Volume:  35     ISSN:  0731-3810     ISO Abbreviation:  J. Toxicol. Clin. Toxicol.     Publication Date:  1997  
Date Detail:
Created Date:  1997-12-04     Completed Date:  1997-12-04     Revised Date:  2014-07-29    
Medline Journal Info:
Nlm Unique ID:  8213460     Medline TA:  J Toxicol Clin Toxicol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  617-20     Citation Subset:  AIM; IM    
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MeSH Terms
Acute Disease
Fatal Outcome
Gas Chromatography-Mass Spectrometry
Glycine Agents / pharmacokinetics*,  poisoning
Poisoning / etiology,  metabolism*,  therapy
Pulmonary Embolism / chemically induced,  metabolism*,  therapy
Strychnine / pharmacokinetics*,  poisoning
Reg. No./Substance:
0/Glycine Agents; H9Y79VD43J/Strychnine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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