Dimethylformamide metabolism following self-harm using a veterinary euthanasia product

Background. A veterinary euthanasia drug containing embutramide, mebezonium, tetracaine, and dimethylformamide (DMF; T-61® or Tanax®) may cause serious manifestations or even fatalities after self-poisoning. Immediate toxicity is mainly due to a general anesthetic and due to a neuromuscular blocking...

Full description

Saved in:
Bibliographic Details
Published in:Clinical toxicology (Philadelphia, Pa.) Pa.), 2010-08, Vol.48 (7), p.725-729
Main Authors: Hantson, Philippe, Villa, Antoine, Galloy, Anne-cécile, Negri, Sara, Esabon, Giulia, Lambiotte, Fabien, Haufroid, Vincent, Garnier, Robert
Format: Article
Language:English
Subjects:
Acetylcysteine - therapeutic use
Acute poisoning
Amides - poisoning
Dimethylformamide - metabolism
Drug Combinations
Hepatotoxicity
Humans
Male
Middle Aged
N-acetylcysteine
Quaternary Ammonium Compounds - poisoning
Suicide
Tetracaine - poisoning
Veterinarians
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background. A veterinary euthanasia drug containing embutramide, mebezonium, tetracaine, and dimethylformamide (DMF; T-61® or Tanax®) may cause serious manifestations or even fatalities after self-poisoning. Immediate toxicity is mainly due to a general anesthetic and due to a neuromuscular blocking agent, while delayed hepatotoxicity seems related to the solvent DMF. The protective role of N-acetylcysteine (NAC) administration remains debatable. Material and methods. Two male veterinarians (50- and 44-year-old) attempted suicide by injecting T-61 in the precordial area for the first one, and by ingesting 50 mL for the second. Both received NAC (for 14 days in the first case and only for 20 h in the second). Urine was collected for the serial determination of DMF, N-methylformamide (NMF), and N-acetyl-S-(N-methylcarbamoyl)cysteine (AMCC). Results. Both patients developed only mild signs of liver injury. The metabolite of DMF, NMF, appeared rapidly in the urine, while a further delay was necessary for AMCC excretion. The kinetics of elimination of DMF and DMF metabolites were slightly slower than those reported in exposed workers. Conclusions. While both patients had a favorable outcome, there is no clear evidence that NAC could directly influence NMF and AMCC excretion. Further investigations of NMF and AMCC excretion, with and without NAC, would be indicated.
ISSN:1556-3650
1556-9519
DOI:10.3109/15563650.2010.498790