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[Suicide with acetylsalicylic acid].

Heike Wollersen1, Johanna Preuss, Annette Thierauf

  • 1Institut für Rechtsmedizin der Universität Bonn.

Archiv Fur Kriminologie
|June 2, 2007
PubMed
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A man died from acetylsalicylic acid (Aspirin) overdose after ingesting 200 tablets. Lethal salicylate levels were found in blood and organs, indicating a severe toxicological outcome.

Area of Science:

  • Toxicology
  • Clinical Chemistry

Background:

  • Acetylsalicylic acid (Aspirin) is a common medication with potential for toxicity at high doses.
  • Suicide attempts involving medication overdose present significant clinical challenges.

Observation:

  • A 41-year-old male ingested approximately 65g of acetylsalicylic acid (200 tablets).
  • Initial symptoms were delayed, with vomiting after 4-5 hours and severe intoxication (convulsions, cardiac arrhythmia) appearing 11 hours post-ingestion.
  • Emergency resuscitation efforts were unsuccessful.

Findings:

  • Chemical-toxicological analysis revealed high salicylate concentrations in blood (475-557 mg/L at 12 hours post-ingestion).
  • Post-mortem analysis confirmed lethal salicylate levels in heart blood (762 mg/L), femoral blood (215 mg/L), liver (503 mg/L), and brain (251 mg/L).

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Implications:

  • This case highlights the delayed onset of severe toxicity and the critical importance of rapid salicylate level monitoring in overdose cases.
  • Understanding the pharmacokinetics and toxicodynamics of acetylsalicylic acid is crucial for managing overdose and improving patient outcomes.