A Case of Mental Change in a Patient Who Received a Zoletil Injection

조레틸 주사 후 의식 변화를 주소로 내원한 환자 1례

  • Lee, Yeong Ki (Department of Emergency Medicine, Konyang University College of Medicine) ;
  • Kang, In Gu (Department of Emergency Medicine, Konyang University College of Medicine) ;
  • Park, Cheol Sang (Department of Emergency Medicine, Konyang University College of Medicine) ;
  • Heo, Seok Jin (Department of Emergency Medicine, Konyang University College of Medicine) ;
  • Chai, Youn Seok (Department of Emergency Medicine, Konyang University College of Medicine) ;
  • Park, Seong Soo (Department of Emergency Medicine, Konyang University College of Medicine) ;
  • Lee, Jae Kwang (Department of Emergency Medicine, Konyang University College of Medicine) ;
  • Kim, Hyun Jin (Department of Emergency Medicine, Konyang University College of Medicine) ;
  • Jeong, Won Joon (Department of Emergency Medicine, Chungnam National University Hospital)
  • 이영기 (건양대학교 의과대학 응급의학교실) ;
  • 강인구 (건양대학교 의과대학 응급의학교실) ;
  • 박철상 (건양대학교 의과대학 응급의학교실) ;
  • 허석진 (건양대학교 의과대학 응급의학교실) ;
  • 채연석 (건양대학교 의과대학 응급의학교실) ;
  • 박성수 (건양대학교 의과대학 응급의학교실) ;
  • 이재광 (건양대학교 의과대학 응급의학교실) ;
  • 김현진 (건양대학교 의과대학 응급의학교실) ;
  • 정원준 (충남대학교 의과대학 응급의학교실)
  • Received : 2012.11.06
  • Accepted : 2013.06.01
  • Published : 2013.06.13

Abstract

Zoletil is a non-opioid, non-barbiturate animal anesthetic and proprietary combination of two drugs, a dissociative anesthetic drug, tiletamine, with the benzodiazepine anxiolytic drug, zolazepam. Zoletil has greater potency than ketamine. Zoletil is abused for recreational purposes, especially by people with easy access to medicine. However, in Korea, it is available over-the-counter. Here we report on a case of an 83-year-old woman who received injection of seven vials of "Zoletil 50" by her daughter and presented with an altered mental change. Her mental state was stupor and vital sign was hypotension, bradycardia. Her blood tests indicated metabolic and respiratory acidosis and hyperkalemia. She was treated with intravenous naloxone and flumazenil but was not responsive. She was admitted to the ICU and treated with supportive therapy. Her mental state showed transient recovery, however, her clinical manifestation worsened and she expired.