It’s for a throw-away line in a story I’m writing. A group of characters are in a city under attack by a particularly cruel enemy, and one of the female characters asks a doctor in the group if she has any Chemical X in her medical bag because death is better than what faces them if they are captured. It’s a fantasy story, so whatever substance I use will be renamed somehow; if I were going to say tylenol, for instance, I’d change it to paracetin or some such. If you could also tell me the common use of the substance, that would be great.
IANAD, but almost anything will kill you if you take enough of it. A bottle of Tylenol, for example, has an excellent chance of utterly shredding one’s liver. It’s an interesting death from a narrative perspective, actually - your character would suffer a lot of pain, probably pass out, and then wake up feeling a lot better. However, her liver would be fried, and she’d die a slow, agonizing death from liver failure. She’d have plenty of time to regret her choice, beg other characters to save her, etc.
Not at all. But they enemy is known for forcing women into breeding farms until they die, so at least one of the characters might consider anything that kills within an hour to be a blessing.
Hmm. That actually is something I could use. They layperson character could ask the doctor if she has Substance X, prompting the doctor to say it’s not quick and recommend Substance Y.
Robin Cook writes good medical thriller. I think he’s used the vemon of a frog or snake in one story and in the other, the nurse put sodium or potassium in an IV and that disguised the result of an autopsy while killing the person by throwing off electrolytes
How about colchicine? Fairly commonly prescribed and toxic in 2-5 hours. I dont know the dosage to be toxic, but the dose is very tiny, and I have very strict instructions on how to take it. I would say that the 120 hit bottle I have as a prescription would probably be pretty toxic if chugged down with a bottle of tylenol back.
Actually there are probably things you could combine, like grapefruit juice hypering the metablization of some drugs…
Wouldn’t Potassium injected directly be fairly rapidly fatal?
Also, in addition to opiates (which would normally be fairly tightly controlled) I’d imagine a strong dose of cyclobenzeprine (a muscle relaxant) followed by a shot or two of booze would be faster and a lot more painless…
In one of rather grim criminal cases here paramedics were accused of killing some patiens with injections of Pavulon. It’s quite potent muscle relaxant which can make you stop breathing when used in large enough dose. It’s used as an aid to intubation and therefore can be realistically found in any ambulance.
Let’s see… botox is pretty lethal in large amounts.
Muscle relaxants.
Barbituates + alcohol, or any other sedative
Any opiate, in large enough quantity
Insulin
Another possibility could be warfarin. It’s used both as a rat poison and as a heart medication, a connection which is known to many. So your hypothetical patient might know it as a poison which is also a medicine, and therefore ask for it. I don’t know if a medic would typically have it in the little black bag, but if not, that could be another reason for the medic to suggest an opiate instead.
And I don’t think you need to worry about changing the names… Most of the things which are particularly dangerous are also controlled, and everyone already knows that a high enough dosage of morphine is lethal.
You won’t find it in an ambulance in california, and I’d be surprised if you found it on one anywhere in the US. A pt who requires pavulon to be intubated, doesn’t need to be intubated in the field, at least not enough to risk the potential complications. Plus, it has no sedating effects, so you’re going to be fully conscious of the fact that you are paralyzed and can’t breathe while you die, I’ll take a pass.
Also, insulin is quite fatal to diabetics as well as non-diabetics, it’s all dosing baby. This is nice, you just drift away, slip into a coma and shuffle off the mortal coil
Lastly, tylenol OD is bad news, if someone told me ‘it’s that, or an alien is gonna rip outta your chest,’ I’d have to give it 'er some thought.
The reason I’m changing the names is to remain in keeping with the fantasy setting, while nevertheless maintaining a logical chain between the items’ in-story name and real-world counterparts.
You could have the character ask the doctor if he has enough morphine to kill them, and have the doctor reveal that he’s gotten ahold of some etorphine or carfentanil from a veterinarian instead. Those are powerful opioids that are 1,000 and 10,000 times stronger than morphine, respectively, and are only commonly used as large animal tranquilizers because even a drop on your skin can be lethal within minutes.
Also, opiates have the following literary benefits:
A) Their effects are completely reversible with standard antagonists like naloxone if the bad guys catch them in time (i.e., before significant brain damage or death occurs from anoxia), so you could have the heroine or whoever go to sleep thinking she’s headed for blissful oblivion and then awaken to discover that her captors have revived her and she’s headed for the horrors of the baby farm.
B) With a really strong opioid like etorphine or carfentanil, or a long-lasting opioid like methadone, the effects of the naloxone can wear off before the effects of the drug, so the enemy might think they’ve saved her life, only to have her suddenly fall back into a coma an hour later after the antidote has worn off, and, oh no, they used up all they with the first injection just to get her to come around!
The other point to make about warfarin is that the difference between the least effective dose and a dangerous dose is rather small. Add to that people vary widely in their response. I take 40 mg per week but others apparently take as few as 7mg. (The tablets themselves come in sizes between 1 and 5 mg and are scored to be easily broken in two.) Users are still monitored at least every six weeks and dosage adjusted regularly. A friend of mine nearly died from a brain hemmorhage when his clotting time suddenly shot up without warning.
