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Survival Following Massive Barbiturate Ingestion

Martin Terplan, MD; Allan M. Unger, MD
JAMA. 1966;198(3):322-323. doi:10.1001/jama.1966.03110160150052.
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BARBITURATE intoxication is becoming increasingly common. The prevalence of unsuccessful suicide attempts in this country has been reported to be almost 4% of the general urban population,1 and, at least in San Francisco, drug ingestion is the most commonly used method for suicide.2 This report concerns a patient who ingested 20 gm of amobarbital (Amytal) with a measured level of barbiturate in the blood of 16 mg/100 ml. To our knowledge, survival after a dose of this magnitude has not been recorded.

Report of a Case  A 52-year-old single, white man, a known hypertensive diabetic, was admitted comatose and apneic to a community hospital approximately two hours after having ingested one hundred 0.2-gm amobarbital capsules. His initial management included placement of an indwelling bladder catheter, an endotracheal tube with positive pressure breathing, and fluids including mannitol and metaraminol (Aramine) bitartrate via venous cutdowns. An attempt to pass a


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