This study describes our analysis, carried out on another
case of attempted suicide by BASTA fluid® ingestion, in
which we were able not only to analyze the toxicokinetics of
DL-GLUF enantiomers, but also to confirm their distribution
to the cerebrospinal fluid.
Case Report A 50-year old Japanese man (weighing
67.0 kg) attempted to commit suicide by ingesting about
100 ml of BASTA (containing DL-GLUF 18.5 g, with DGLUF
and L-GLUF present in the ratio of 1 : 1). On discovering
evidence of nausea and vomiting, and of fecal incontinence,
his younger brother called an ambulance, and the subject
was brought to our hospital an hour after ingesting the
poison. On admission, he complained of throat pain and exhibited
a normal level of consciousness. His blood pressure
was 116/68 mmHg, heart rate 100 beats/min, and no neurological
symptoms were evident. The results of blood examinations
and renal function tests were within normal limits
(serum creatinine, 0.7 mg/dl). The contents of the stomach
were aspirated through a nasal tube, but turned out to be
scanty, and so neither gastric lavage nor administration of activated
charcoal was performed. Intravenous fluid infusion
was conducted to maintain the daily urine volume above
2000 ml. Diuretics were not used. Eighteen and a half hours
after ingestion, the respiration rate slowed, but the patient
was fully conscious. At the 26th hour after ingestion, his respiration
was seen to be seriously inhibited. He was sedated
by continuous infusion of midazolam (5.8 mg/h), and ventilatory
support was initiated. After 4 d of artificial ventilation,
midazolam was discontinued, and he was extubated. He has
shown no neurological symptoms since that time, and his
clinical course was uneventful. He was discharged without
any sequelae after 11 d of hospitalization. His serum creatinine
and urea nitrogen were within the normal range
throughout his hospitalization.