Vecuronium bromide: preferred suicidal drug among medical professionals – a case report
Keywords:
Vecuronium bromide; Muscle relaxant; Suicide; Nursing studentAbstract
We report a case of suicidal death due to self-administration of intravenous vecuronium bromide by a nursing student. Toxicological analysis confirmed the presence of vecuronium bromide. Postmortem findings, toxicological analysis, and crime scene investigation indicated a suicidal manner of death, with the cause attributed to respiratory paralysis resulting from vecuronium injection. Skeletal muscle relaxants act either peripherally at the neuromuscular junction or centrally on the cerebrospinal axis to reduce muscle tone. Neuromuscular blocking agents are commonly used in general anesthesia during surgery to induce muscle relaxation. Centrally acting muscle relaxants are primarily used for treating painful muscle spasms and spastic neurological disorders.References
Finkel R, Clark MA, Cubeddu LX, editors. Lippincott’s illustrated reviews: pharmacology. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2009. p.59-62, 137.
Detweiler CJ, Mambo NC. Suicide with vecuronium and etomidate: a case report and review of the literature. Acad Forensic Pathol. 2014;4(2):244-250.
Xue FS, An G, Liao X, Zou Q, Luo LK. Pharmacokinetics of vecuronium in male and female patients. Anesth Analg. 1998;86(6):1322-1327.
Appiah-Ankam J, Hunter JM. Pharmacology of neuromuscular blocking drugs. Contin Educ Anaesth Crit Care Pain. 2004;4(1):2-7.
Brunton LL, editor. Goodman and Gilman’s the pharmacological basis of therapeutics. 12th ed. New York: McGraw-Hill Education; 2011.
Tripathi KD. Essentials of medical pharmacology. 6th ed. New Delhi: Jaypee Brothers Medical Publishers; 2010.
Butterworth JF, Mackey DC, Wasnick JD. Morgan and Mikhail’s clinical anesthesiology. 5th ed. New Delhi: Tata McGraw Hill; 2013.
Miller RD, editor. Miller’s anesthesia. 7th ed. Philadelphia: Churchill Livingstone Elsevier; 2010.
Yadukul S, Suresh V, Havanur B. Paramedic suicide with vecuronium bromide: a case report. J Forensic Toxicol Pharmacol. 2014;3(2).
Detweiler CJ, Mambo NC. Suicide with vecuronium and etomidate: a case report and review of literature. Acad Forensic Pathol. 2014;4(2):244-250.
Ingale D, Bagali MA, Anand M, Raju S, Jatti VB. Suicide by intravenous injection of vecuronium bromide. J Indian Soc Toxicol. 2013;9:43-46.
Maria AM, Salone B, Elena A. Anaesthesiologist suicide with atracurium. J Anal Toxicol. 2006;30:120-124.
Kintz P, Tracqui A, Ludes B. Distribution of laudanosine in tissues after death from atracurium injection. Int J Legal Med. 2000;114:93.
Martinez MA, Ballesteros S, Almarza E. Anesthesiologist suicide with atracurium. J Anal Toxicol. 2006;30(2):120-124.
Vorce SP, Mallak CT, Jacobs A. Quantitative analysis of the amino steroidal non-depolarizing neuromuscular blocking agent vecuronium by LC-ESI-MS: a postmortem investigation. J Anal Toxicol. 2008;32(6):422-427.
