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Barceló B, Gomila I, de-Castro-Ríos A, Perez-Barcena J, Jimenez C, Lendoiro E, Elorza MÁ. Diminished Consciousness in a Woman Following an Unsuspected Scopolamine Overdose. J Anal Toxicol 2021; 45:e7-e14. [PMID: 33025011 DOI: 10.1093/jat/bkaa135] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/20/2020] [Accepted: 09/28/2020] [Indexed: 11/12/2022] Open
Abstract
Scopolamine is used clinically, but it is also used as a recreational drug and as an incapacitating drug, in sexual crimes and robberies. In this paper, the authors report the case of a woman with a diminished consciousness following an unsuspected overdose with scopolamine and review published articles on scopolamine poisoning that included concentrations in biological samples. Scopolamine was identified in the patient's serum and urine samples collected 1 h post-admission to intensive care unit at concentrations of 8.4 ng/mL and 62,560 ng/mL (169,539 ng/mg creatinine), respectively. In non-fatal cases, the median [interquartile range] of serum scopolamine levels was 1.9 [2.1] ng/mL. The serum concentration found in our case would explain the abrupt clinical presentation suffered by the patient. Scopolamine in urine could be detected up to 48 h after admission. This report illustrates that broad toxicology screening, including scopolamine, should be considered when patients with diminished consciousness are attended after ruling out infection or cerebrovascular disease. This can play an important role in identifying this potentially life-threatening etiology.
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Affiliation(s)
- Bernardino Barceló
- Clinical Toxicology Unit, Clinical Analysis Department, Hospital Universitari Son Espases. Research Institute of Health Sciences (IdISBa), Valldemossa road 79, 07120 Palma de Mallorca, Spain
| | - Isabel Gomila
- Clinical Analysis Department, Hospital Universitari Son Llàtzer. Research Institute of Health Sciences (IdISBa), Manacor road, 07198 Palma de Mallorca, Spain
| | - Ana de-Castro-Ríos
- Servicio de Toxicología, Instituto de Ciencias Forenses "Luis Concheiro". Universidade de Santiago de Compostela, San Francisco s/n, 15782 Santiago de Compostela, Spain
| | - Jon Perez-Barcena
- Intensive Care Department, Hospital Universitari Son Espases, Research Institute of Health Sciences (IdISBa), Valldemossa road 79, 07120 Palma de Mallorca, Spain
| | - Carmen Jimenez
- Neurology Department, Hospital Universitari Son Espases, Research Institute of Health Sciences (IdISBa), Valldemossa road 79, 07120 Palma de Mallorca, Spain
| | - Elena Lendoiro
- Servicio de Toxicología, Instituto de Ciencias Forenses "Luis Concheiro". Universidade de Santiago de Compostela, San Francisco s/n, 15782 Santiago de Compostela, Spain
| | - Miguel Ángel Elorza
- Clinical Toxicology Unit, Clinical Analysis Department, Hospital Universitari Son Espases. Research Institute of Health Sciences (IdISBa), Valldemossa road 79, 07120 Palma de Mallorca, Spain
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Koželj G, Perharič L, Stanovnik L, Prosen H. Simple validated LC–MS/MS method for the determination of atropine and scopolamine in plasma for clinical and forensic toxicological purposes. J Pharm Biomed Anal 2014; 96:197-206. [DOI: 10.1016/j.jpba.2014.03.037] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Revised: 03/18/2014] [Accepted: 03/24/2014] [Indexed: 11/29/2022]
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KASAHARA Y. A Recent Tendency of Food Poisoning Caused by Toxic Plants and Its Problem Awaiting Solution. Food Hygiene and Safety Science (Shokuhin Eiseigaku Zasshi) 2010; 51:311-8. [DOI: 10.3358/shokueishi.51.311] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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