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Phenobarbital poisoning and various toxicities: case report A 37-year-old woman developed unconsciousness, tachypnoea, myotonic pupil, impaired blood gasometry, toxic encephalopathy, decreased oxygen saturation, decreased RR and decreased BP following phenobarbital poisoning. Additionally, alprazolam contributed to the toxicities [indications, dosages, routes and time to reaction onsets not stated]. The woman presented to the emergency room with reduced consciousness. Her companion reported a possibility that she had taken unknown amount of alprazolam pills. Initially, she had tachypnoea and was unconscious. Analysis of head and neck showed myotonic pupils without responses to light. At that time, she had low oxygen saturation, RR and impaired blood gasometry. Consequently, she was intubated and underwent mechanical ventilation. The disorder in venous blood gas was corrected by mechanical ventilation. Blood tests showed phenobarbital blood level of 120 mg/dL. Hence, the diagnosis of phenobarbital poisoning was confirmed. The woman’s treatment for phenobarbital poisoning was started. Initially, dialysis was decided; however, due to decreased BP, haemodynamic adjustments were made initially, and then, dialysis was started. Her phenobarbital blood level decreased slightly but she remained unconscious suggesting toxic encephalopathy. Her consciousness increased and breathing improved following the second cycle of dialysis. Subsequently, she was extubated and her condition continued to improve. Ataee Z, et al. A letter about phenobarbital poisoning. International Journal of Medical Toxicology and Forensic Medicine 10: No. 2, 2020. Available from: URL: http:// 803517407 doi.org/10.32598/ijmtfm.v10i2.29079

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Reactions 28 Nov 2020 No. 1832