van der Heijden Lisa T, van den Hondel Karen E, Olyslager Erik J H, de Jong Lutea A A, Reijnders Udo J L, Franssen Eric J F
Department of Pharmacy & Pharmacology, Antoni van Leeuwenhoek/The Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands.
Division of Pharmacology, Antoni van Leeuwenhoek/The Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands.
Toxics. 2023 Jul 13;11(7):608. doi: 10.3390/toxics11070608.
There has been a significant increase in sodium azide intoxications since the 1980s. Intoxications caused by sodium azide are becoming increasingly prevalent in the Netherlands as a result of its promotion for the purpose of self-euthanasia. The mechanism of toxicity is not completely understood but is dose-dependent. The presented case describes a suicide by sodium azide of a young woman (26 years old) with a history of depression and suicide attempts. The decedent was found in the presence of prescription medicine, including temazepam, domperidone in combination with omeprazole, and the chemical preservative sodium azide. Quantitative toxicology screening of whole blood revealed the presence of 70 µg/L temazepam (toxic range > 1000 µg/L) and 28 mg/L sodium azide (fatal range: 2.6-262 mg/L). Whole blood qualitative analysis revealed the presence of temazepam, temazepam-glucuronide, olanzapine, n-desmethylolanzapine, and acetaminophen. In circles promoting sodium azide, it is recommended to use sodium azide in combination with medications targeting sodium azide's negative effects, such as analgesics, antiemetics, and anti-anxiety drugs. The medicines recovered at the body's location, as well as the results of the toxicology screens, were consistent with the recommendations of self-euthanasia using sodium azide.
自20世纪80年代以来，叠氮化钠中毒事件显著增加。由于叠氮化钠被用于协助安乐死，其导致的中毒事件在荷兰正变得越来越普遍。中毒机制尚未完全明了，但具有剂量依赖性。本病例描述了一名患有抑郁症且有自杀未遂史的26岁年轻女性服用叠氮化钠自杀的事件。死者被发现时身旁有处方药，包括替马西泮、多潘立酮与奥美拉唑的组合以及化学防腐剂叠氮化钠。全血定量毒理学筛查显示，替马西泮含量为70µg/L（中毒范围>1000µg/L），叠氮化钠含量为28mg/L（致死范围：2.6 - 262mg/L）。全血定性分析显示存在替马西泮、替马西泮 - 葡萄糖醛酸苷、奥氮平、去甲基奥氮平和对乙酰氨基酚。在推广叠氮化钠的群体中，建议将叠氮化钠与针对其副作用的药物联合使用，如镇痛药、止吐药和抗焦虑药。在尸体发现地点找到的药物以及毒理学筛查结果与使用叠氮化钠进行安乐死的建议相符。
