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Lack of correlation between plasma 4-hydroxyglutethimide and severity of coma in acute glutethimide poisoning. A case report and brief review of the literature.

Abstract
Glutethimide poisoning is characterised by coma, anticholinergic poisoning syndrome, hypotension, and other complications. Previous studies have shown that the severity of intoxication does not correlate with plasma glutethimide concentrations in individual patients. Glutethimide is partly converted to 4-hydroxyglutethimide, a metabolite which accumulates in the plasma of humans, and which has been thought to contribute to coma after plasma glutethimide concentrations have fallen. We followed plasma concentrations of glutethimide and 4-hydroxyglutethimide in a man who overdosed with glutethimide. Plasma 4-hydroxyglutethimide concentrations did not correlate with the degree of coma in our patient, and actually rose as the patient awakened. Other studies also indicate that 4-hydroxyglutethimide may not play an important role in glutethimide poisoning.
AuthorsS C Curry, J M Hubbard, R Gerkin, B Selden, P J Ryan, R Meinhart, D Hagner
JournalMedical toxicology and adverse drug experience (Med Toxicol Adverse Drug Exp) 1987 Jul-Aug Vol. 2 Issue 4 Pg. 309-16 ISSN: 0113-5244 [Print] New Zealand
PMID3626855 (Publication Type: Case Reports, Journal Article)
Chemical References
  • 4-hydroxyglutethimide
  • Glutethimide
Topics
  • Coma (chemically induced)
  • Glutethimide (analogs & derivatives, blood, poisoning)
  • Humans
  • Kinetics
  • Male
  • Middle Aged
  • Suicide

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