British Journal of Clinical Pharmacology
DOI:10.1111/bcp.12495
Letter to the Editors
A new challenge: suicide attempt using nicotine fillings for electronic cigarettes Eleonora M. Schipper,1* Laura C. G. de Graaff,1* Birgit C. P. Koch,2 Zina Brkic,2 Erik B. Wilms,3 Jelmer Alsma1 & Stephanie C. E. Schuit1 1
Department of Internal Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands, 2Hospital Pharmacy, Erasmus University Medical Centre, Rotterdam, The Netherlands and 3Laboratory of Pharmaceutical Analysis and Toxicology, Central Hospital Pharmacy, The Hague, The Netherlands
Introduction Electronic cigarettes are gaining popularity as an alternative to traditional cigarettes, with sales increasing from $283 million in 2012 to $537 million in 2013 in the USA [1]. Although they are considered relatively safe, the highly concentrated nicotine fillings (‘e-liquid’) can cause potentially lethal poisoning when ingested. Information about intoxications with e-liquid is scarce [2–4]. Recent reports show a significant increase in the number of reported cases of poisoning with fillers from electronic cigarettes [5, 6], representing both accidental and intentional poisonings.
Case description Recently, a previously healthy 27-year-old man with a borderline personality disorder presented at our emergency department 1 h after ingestion of five e-liquid fillings in an suicide attempt. He had also consumed five units of wine. The e-liquid fillings contained a total of 420 mg of nicotine and unknown amounts of propyleneglycol and glycerine (Figure 1). Before arrival at the emergency department, the patient had vomited three times, but upon arrival he was free of complaints. The patient denied ingestion of other substances (aside from the reported ethanol). The paramedics found no other empty containers in the patient’s house, nor were there any drugs visible in the vomitus. The serum concentration of acetaminophen was also not detectable (
DOI:10.1111/bcp.12495
Letter to the Editors
A new challenge: suicide attempt using nicotine fillings for electronic cigarettes Eleonora M. Schipper,1* Laura C. G. de Graaff,1* Birgit C. P. Koch,2 Zina Brkic,2 Erik B. Wilms,3 Jelmer Alsma1 & Stephanie C. E. Schuit1 1
Department of Internal Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands, 2Hospital Pharmacy, Erasmus University Medical Centre, Rotterdam, The Netherlands and 3Laboratory of Pharmaceutical Analysis and Toxicology, Central Hospital Pharmacy, The Hague, The Netherlands
Introduction Electronic cigarettes are gaining popularity as an alternative to traditional cigarettes, with sales increasing from $283 million in 2012 to $537 million in 2013 in the USA [1]. Although they are considered relatively safe, the highly concentrated nicotine fillings (‘e-liquid’) can cause potentially lethal poisoning when ingested. Information about intoxications with e-liquid is scarce [2–4]. Recent reports show a significant increase in the number of reported cases of poisoning with fillers from electronic cigarettes [5, 6], representing both accidental and intentional poisonings.
Case description Recently, a previously healthy 27-year-old man with a borderline personality disorder presented at our emergency department 1 h after ingestion of five e-liquid fillings in an suicide attempt. He had also consumed five units of wine. The e-liquid fillings contained a total of 420 mg of nicotine and unknown amounts of propyleneglycol and glycerine (Figure 1). Before arrival at the emergency department, the patient had vomited three times, but upon arrival he was free of complaints. The patient denied ingestion of other substances (aside from the reported ethanol). The paramedics found no other empty containers in the patient’s house, nor were there any drugs visible in the vomitus. The serum concentration of acetaminophen was also not detectable (
