Abuse of telazol: An animal tranquilizer

Background: Telazol((R)) (tiletamine hydrochloride 50 mg/mL, zolazepam hydr ochloride 50 mg/mL) is utilized in veterinary medicine as a small-animal an esthetic. Telazol is comparable to ketamine in efficacy, and in conjunction with ketamine, has been responsible for one reported human fatality. We re port a case of a woman who abused telazol. Case Report: A 30-year-old femal e employee at a local Zoo was found unresponsive by fellow workers in a cle an animal treatment room. Initial reports were that she had injected veteri nary-grade diazepam and telazol. On-scene paramedics reported her as obtund ed and arousable to deep painful stimuli, with gag reflex intact. Systolic blood pressure was 90 min Hg ky palpation. Afresh needle puncture mark was present on her right arm; nearby were a syringe, tourniquet, and bottles of each drug. Emergency Department assessment included airway, breathing, cir culation, and intravenous access. She was lavaged and given activated charc oal with a cathartic. Shortly after arrival, she became alert and oriented. Family members insisted this was not an overdose. The patient had been pre viously evaluated for reported episodes of syncope, "only in the evening, w hile at work," and was prescribed diazepam for anxietly. Product informatio n on telazol was limited to the Veterinary Drug Physician's Desk Reference. A urine drugs-of-abuse screen was positive benzodiazepines and cannabinoid s. The patient subsequently revealed a history of recreational use of telaz ol. She was discharged to an in-patient detoxification facility, 12 hours p ostadmission. Conclusion: Telazol used in veterinary medicine as an anesthe tic, agent, is structurally related to ketamine. Telazol causes almost imme diate anesthetic effects; and sudden alertness is not uncommon as the eft c ts of the drug subside. Urine drugs-of-abuse screens are unlikely to identi fy telazol. We report a veterinary worker who abused telazol.