You knew this had to have a page: Instant Sedation
(Danger! Danger! Danger, Will Robinson! TVTropes link!)
What about the scenes in the Hannibal Lecter movies and others- or in the show Community for that matter- where they hold a rag (presumably soaked in chloroform) to the nose and the person goes out instantly? Is that at all realistic?
Chloroform poisoning, made with homemade chloroform no less, is currently a suspected factor in the Caylee Anthony case.
Another old thread on etorphine. To quote Wikipedia, “Veterinary-strength etorphine is fatal to humans.” No way it could actually be used on people, so its use on the show is “artistic license”.
Whoa, zombie Dexter thread.
If he shoots it in the carotid artery, am I correct to assume that the drug wouldn’t need to make a round-trip to the heart? Wouldn’t it go directly to the brain in a fraction of a second?
How would it work on zombies?
Why would anyone do this? I mean, pentothal at those doses isn’t going to be euphoric, is it? And you’re going to be groggy as hell the next morning. What’s the point?
Also, why is he shooting up in the garage of all places? If it kicks in that fast, and for some crazy reason you inject yourself with this, why not just do it in bed?
I was going to say “So is getting hacked up by a serial killer”, but I think that’s a little too fatal.
But there’s nothing to say he’s using it at veterinary strength.
In one episode he tried to tranq an absolutely enormous man, and it failed.
I don’t know anything about etorphine in particular, but the way that opiods kill people is from knocking out their respiratory drive. <fanwank> If Dexter used a bag-valve mask or some other way of keeping them oxygenated presumably he could keep them alive. Or he uses just the right dose to sedate them but not knock out their respiratory drive. </fanwank>
I’m a paramedic, and we carry Narcan and get plenty of opportunities to use it. The trick is to use small doses and just enough to get the person breathing again, but not enough to wake them up. If you give too much to an addict they’ll puke their brains out from the withdrawal, and probably become violent.
Dexter actually said M99 in one of the episodes.
Um… why not just keep a vial and needle in his bedside table?
Was the absolutely enormous man also an opioid addict? If someone has a tolerance to one opioid, they may need staggering doses of another in the hospital for it to be effective, no matter what their body mass.
Well, dude…you totally ruined their buzz, man! How could you?! That was, like, the really GOOD shit! 
(Nursing note: when the paramedic brings in a patient who got Narcan, get more Narcan ready. It will usually wear off much faster than whatever the patient took, and more Narcan is a lot easier than starting CPR. Less paperwork, too.)
correct… arteries exit the heart, so injecting in the carotid would obviously bypass the blood-brain-barrier, and the drug would act immediately on receptors in the brain…
not sure how easily you can stop the bleeding, though, from a direct injection to the carotid…
The only thing missing from the OP is “Need answer fast”.
Substances in the bloodstream still have to pass through the blood-brain barrier to act on the brain, even if they are injected directly into a carotid artery. The blood-brain barrier is the consequence of the tight connections between the endothelial cells that line all the blood vessels in the brain: arterial, capillary, and venous. Because the endothelial cells are so tightly ‘cemented’ together, and externally reinforced by exuded proteins and further wrapped by other cells, only very small molecules can diffuse directly from the blood, through the gaps in the BBB, and enter the extracellular fluid in the brain.
There are certain portions of the brain where the blood-brain barrier is weak or no stronger than in the rest of the body, to allow for the passage of larger molecules.
He didn’t want his family to see him do it, hence the secretiveness.
Hey I’m new, don’t know how often I’ll come around but I’m procrastinating from studying, and just got done studying this very topic. I’m not a doctor, but a medical student, and also love the show Dexter. So I wanted to try to answer some of this.
It is dose-dependent. All that means is that if he wanted to use it on humans without killing them, he would have to dilute it at least 50-fold.
The blood brain barrier is not bypassed for that reason. The blood brain barrier refers to tight junctions between endothelial cells in the capillaries of the brain.
The blood brain barrier is crossed by lipid soluble drugs. For this reason, the potency of anesthetics is directly correlated with how fat soluble the drug is. If it can’t get to the brain easily because it is not fat soluble, it will be more widely distributed throughout the rest of the body and will be excreted before it has as much of an effect.
The onset of action is an independent property from potency and inversely related to water solubility. So while the fact that etorphine is potent means you can get a large effect from a small amount, it does not mean it acts fast. Incidentally etorphine does act fast, but not because it is potent.
One that is actually used in humans that would act about as fast as in the show is methohexital, but only if he hit the carotid artery. Otherwise it would take minutes. Most commonly used fast-acting anesthetics take 30 seconds to 1 minute to take effect.
Wanted to add something but didn’t realize I only had 5 minutes to edit…
Should note that drugs of any kind are not normally injected into arteries and can cause tissue damage when injected into arteries, but I’m not sure how much it would matter if you’re going to kill them anyway - they could have a stroke before he has a chance to talk to them. It is, however, true that if he were going for the jugular vein that it would take longer than the carotid. Artery catheters are done, so it’s not like it would be unrealistic, but in healthcare they’re normally placed for diagnostic purposes.
And how did he explain the occasional “Daddy’s napping in the garage again” moments?