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4090298 
Journal Article 
Xylazine Injection in Man 
Wolowich, WR; Mcpeak, J; Good, TG; Casavant, MC 
2003 
1 
Journal of Toxicology: Clinical Toxicology
ISSN: 0731-3810
EISSN: 1097-9875 
TOX/4000013 
41 
5 
English 
Background: Xylazine is an alpha-2 agonist used as an animal tranquilizer; the LD50 in dogs is 47 mg/kg. Case Report: A 52 y. o. 97 Kg male was brought to the ED at 02:00 h after IM injection of 2.5 g xylazine, (25.8 mg/kg) (Rompum? Bayer) and ingestion of the balance (2.5 g) of the 50 mL vial in a suicide attempt. The patient had a history of depression and was prescribed buproprion. He was disoriented and semiconscious on presentation but aroused to verbal stimuli. He was breathing (rate = 22/min) but had apneic periods of 15 to 20 seconds; pulse oximetry was 89?97%; pulse 74; BP 140/102. Lavage was performed and 100 g charcoal with sorbitol were given at 02:30. Gastric contents were clear, and a pink substance around the mouth was noted. Abnormal laboratory values included: glucose 234 mg/dL, BUN 21 mg/dL, calcium 8.0 mg/dL, WBC 13.4. A screen for drugs of abuse in plasma was negative for amphetamines, barbiturates, benzodiazepines, cannabinoid, cocaine, opiates, and phencyclidine. A sample of blood drawn at 03:00 h did contain xylazine 2 mg/L. Blood glucose remained elevated for 24 h. He recovered without further incident and was discharged 36 hours after admission. Conclusion: Three other cases of self injection of large amounts ( and gt;1 g) of xylazine are reported: a 27 years old male injected 1.5 g (13 mg/kg) IM causing a plasma concentration of 4.6 mg/L (the highest value reported in a human), a 37 years old female injected 2.4 g (22 mg/kg) IM, and a 34 years old male injected 1 g (15 mg/kg) IM. Like our patient, all three patients were hyperglycemic (177, 176, 196 mg/dL). Although the toxidrome ?should? include hypotension, our patient and two of the three above patients were hypertensive upon presentation (180/100, 166/70). Recovery was complete in all cases.