Phenoarbital monitoring in blood, urine and sweat and importance of sweat excretion intoxic coma paients

Abstract

The examination of sweat excretion for the presence of drugs is a promising clinical method. A monitoring of phenobarbital in the blood, urine and sweat in a 22-year old patient in a toxic coma was carried out. Blood and urine samples were taken on the 13th, 26th, 40th, 46th and 58th hour and on the 8th day after the intoxication. Sweat samples were taken on the 11th, 12th and 13th hour after the poisoning. The highest plasma phenobarbital concentration (of 31,82 ig/ml) was registered on the 13th hour. There was a considerable renal excretion (of 49,24 ig/ml). The large volume of phenobarbital distribution became evident on the 46th and 58th hour. After the second day the phenobarbital level in the blood and urine considerably decreased. The sweat phenobarbital excretion was significant on the 13th hour and corresponded to the peak plasma concentration of the drug. Therefore, this excretion after acute intoxication possesses an information and evidence value. Its expert assessment with the cases with drug poisoning in the forensic medical practice could be recommended. Scripta Scientifica Medica 2008;40(1):35-37