Glutethimide poisoning

Hansen AR, Kennedy KA, and Ambre JJ (1975) Glutethimide poisoning A metabolite contributes to morbidity and mortality. New England Journal of Medicine 292 250-252. 

A nonbarbiturate hypnotic. Glutethimide poisoning causes symptoms similar to those of barbiturate poisoning except that they may be more severe. It can be detected in body fluids by ultra violet absorption spectrophotometry after an initial extraction. 

Examination of the mouth provides evidence of exposure to some toxicants. Caustic acids and bases cause a moist condition of the mouth. Other toxicants that cause the mouth to be moister than normal include mercury, arsenic, thallium, carbamates, and organophosphates. A dry mouth is symptomatic of poisoning by tricyclic antidepressants, amphetamines, antihistamines, and glutethimide. 

Toxicity. The estimated minimum lethal dose is 5 g although recoveries have occurred after the ingestion of up to 10 g. Blood concentrations of 3.4 to 27 to 48 pg/ml of glutethimide have been associated with toxic effects and concentrations of 25 to 48 to 90 pg/ml have been associated with fatalities. Postmortem blood concentrations of about lOpg/ml may be indicative of poisoning if the survival time has been prolonged. 

With known intoxicants, an understanding of the pharmacokinetics of the poison can help in the choice of modality and treatment prescription. For instance, drugs with large volumes of distribution such as hthium [27], ethchlorvynol [28], glutethimide [29] may require prolonged (or repeated) treatments to avoid... 

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