Thiamylal: review of the literature and report of a suicide.

A 28-year-old white male medical student was found hanging by the neck from the bathroom closet of a hotel room. An intravenous infusion line leading from a bottle of thiamylal sodium (an ultrashort-acting barbiturate) was inserted into the antecubital vein of the left arm. Blood was analyzed for alcohol and other volatiles and for acidic, basic, and neutral drugs. Only thiamylal was detected. Thiamylal was quantified by high-performance liquid chromatography with ultraviolet detection, and its presence was confirmed by gas chromatography/mass spectrometry. The tissue distribution of thiamylal was 29 mg/L in blood, 1.4 mg/L in urine, 16 mg/L in bile, 135 mg/kg in liver, 25 mg/kg in kidney, and 0.4 mg in the stomach contents. The uptake and distribution of thiamylal is similar to thiopental. The distribution of the drug in this case was compared to that of other fatalities involving ultrashort-acting barbiturates.