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Case report: Survival after deliberate strychnine self-poisoning, with toxicokinetic data

Year: 2002
Type: article
Study design: Case Report
Abstract: INTRODUCTION: Strychnine poisoning is uncommon, and in most severe cases, the patient dies before reaching hospital. The management of strychnine poisoning is well documented, although there are few data on the kinetics of elimination of strychnine after overdose. CASE REPORT: A 42-year-old man presented shortly after ingestion of an unknown quantity of strychnine powder. After a respiratory arrest, with intensive supportive management requiring admission to an intensive care unit, he survived. Eight serum samples were taken over the first 5 days and analysed subsequently for strychnine concentrations. RESULTS: The initial concentration at 1.5 hours after ingestion was 4.73 mg/l, falling to 0.38 mg/l at 74 hours postingestion. Serum concentrations followed a monoexponential elimination curve with a calculated elimination half-life of 12 hours. DISCUSSION AND CONCLUSION: Strychnine poisoning presents with classical features, and with early diagnosis and supportive management, the patient can survive. The initial serum concentration of 4.73 mg/l is the highest reported concentration in a patient who has survived. Previous reports of the elimination half-life have suggested it is between 10 and 16 hours, which conforms to the elimination data in our case.
Authors: David Michael Wood, Emma Webster, Daniel Martinez, Paul Ivor Dargan, Alison Linda Jones
Language: English
Field: Medicine
Open Access status: gold
Estimated APC paid: $4,190
OpenAlex ID: W2108822064
FWCI: 2.209
Cites: 24
Cited by: 69
Related to: 10