#1
Old 12-07-2008, 09:08 PM
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Dexter's Sedative

Hey,

Anyone know what sedative Dexter (you know, the 'good guy' serial killer) supposedly uses? Is there a real sedative that works that fast? It seems like he injects people and they instantly fall unconscious... I figure if something like that really existed, we might hear of a lot more very unpleasant crimes being committed.

Thanks,
thwartme
#2
Old 12-07-2008, 10:06 PM
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Dexter's Wiki page says it's etorphine hydrochloride or M99. Wiki says it's an opioid that can knock out elephants, and it's only approved for veterinary use.
#3
Old 12-07-2008, 10:17 PM
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There are lots of fast-acting sedatives- they are just difficult to obtain.

I knew an MD once who would inject himself with pentothal in order to fall asleep. But he had to time it right, because he'd shoot up in the garage then walk/run to bed. At least a few times, he'd miss the dose and pass out half in and half out of the garage.

QtM knew him, I think. maybe he'll verify or correct the pentothal ID...
#4
Old 12-07-2008, 10:24 PM
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Still, on Dexter they always shows the victim getting stuck and losing consciousness pretty much immediately, without even being able to get a word in edge-wise. I think even the fastest sedatives still take more time than that -- if only to make it to your heart and up to your brain.
#5
Old 12-07-2008, 10:30 PM
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friedo, that fits with the effects of M99:

"M99 (etorphine hydrochloride) was synthesised by Bentley & Hardy (1963) and is chemically related to morphine. When given subcutaneously, M99 is 1,000 to 80,000 times more potent than morphine as an analgesic. Its use for immobilising game animals results largely from its ability to cause catatonia at very low dose levels (for example, the total dose for a rhino may be as low as 5 mg)."

I wonder if Dex gives his victims something else to wake them up after he's taken them to the kill room.

Oh, and one website says that anyone using the drug is required to have an antidote ready to go, in case someone is accidentally scratched by the needle or if it gets on their skin. It sounds like very fast-acting powerful stuff.

Last edited by AuntiePam; 12-07-2008 at 10:31 PM.
#6
Old 12-07-2008, 10:31 PM
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Quote:
Originally Posted by friedo View Post
Still, on Dexter they always shows the victim getting stuck and losing consciousness pretty much immediately, without even being able to get a word in edge-wise. I think even the fastest sedatives still take more time than that -- if only to make it to your heart and up to your brain.
Yeah, that's sort of why I was asking. I feel the writers/directors are taking a little artistic license with how fast the sedative works, I was just wondering how much artistic license.

But, wow. Elephant tranquilizers. Yeah, that'd probably work. You know, I actually know a couple people who work at a zoo ... I'll try to remember not to annoy them...

thwartme
#7
Old 12-07-2008, 10:46 PM
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Originally Posted by AuntiePam View Post
friedo, that fits with the effects of M99:
The effects, sure, but what about the timing? How quickly does the rhino go down after getting stuck with 5mg?
#8
Old 12-07-2008, 11:43 PM
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It seems like they always try to set the scene up so that it looks like he's injecting directly into a carotid artery.

Looking at this, it's a target rich environment. (Why are there decent no anatomical drawings of this that aren't side views .)

CMC +fnord!
#9
Old 12-08-2008, 05:09 AM
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Have a look online for a video of Nadezhda Tylik... she was the mother of one of the victims of the Russian submarine (Kursk) which sank with all hands.

She was arguing with local officials, and film cameras showed a Russian doctor (or FSB Agent...) injecting her with a sedative. It instantly made her unable to speak, and then made her collapse.

http://en.wikipedia.org/wiki/Nadezhda_Tylik

It's quite a chilling video if you can find it.
#10
Old 12-08-2008, 07:33 AM
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Quote:
Originally Posted by friedo View Post
The effects, sure, but what about the timing? How quickly does the rhino go down after getting stuck with 5mg?
Not sure about a rhino, but a human will go down as soon as it hits the bloodstream.

There was an episode in the first season explaining that Dexter forged credentials as a dentist (I think? Maybe a vet?) in order to get the sedative.
#11
Old 12-08-2008, 10:05 AM
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Quote:
Originally Posted by EJsGirl View Post
There are lots of fast-acting sedatives- they are just difficult to obtain.

I knew an MD once who would inject himself with pentothal in order to fall asleep. But he had to time it right, because he'd shoot up in the garage then walk/run to bed. At least a few times, he'd miss the dose and pass out half in and half out of the garage.

QtM knew him, I think. maybe he'll verify or correct the pentothal ID...
Do you mean "Doctor, Alcoholic, Addict" from the Big Book, or did you know someone else in real life who did this?
#12
Old 12-08-2008, 01:51 PM
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I knew Paul, the guy who wrote that, casually.
#13
Old 12-08-2008, 01:58 PM
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I have a buddy who works for a hospital and according to him, they do have drugs which they can inject into you and put you out in a couple of seconds. These tend to get used in the ER, when you've got patients who're less than cooperative for a variety of reasons.

The pharma companies and the doctors tend to be very quiet about discussing these things.
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#14
Old 12-08-2008, 02:48 PM
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Quote:
Originally Posted by neutron star View Post
There was an episode in the first season explaining that Dexter forged credentials as a dentist (I think? Maybe a vet?) in order to get the sedative.
I just watched that episode. I was amused (but a bit disappointed) that his alias was "Patrick Bateman, M.D." Bateman is the serial killer in American Psycho.

I like to think that Dexter is smart enough that he wouldn't use a fictional serial killer to cover his tracks, but I guess the writers couldn't help making a little homage.
#15
Old 12-08-2008, 03:40 PM
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Originally Posted by EJsGirl View Post
I knew Paul, the guy who wrote that, casually.
#16
Old 12-08-2008, 03:44 PM
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Yeah, he and Max were pretty fucking .

#17
Old 12-09-2008, 11:20 AM
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Quote:
Originally Posted by AuntiePam
I wonder if Dex gives his victims something else to wake them up after he's taken them to the kill room.
Missed this the first time I read this thread, but he could do that and have it still be realistic.

Naloxone (brand name: Narcan) is an opiod receptor competetive antagonist that is strong enough to bring someone from the most blissful heroin high of their life (or an overdose) to screaming in agony from opiate withdrawal (if used on an addict) in the space of two minutes.
#18
Old 12-09-2008, 11:54 AM
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Quote:
Originally Posted by friedo View Post
Still, on Dexter they always shows the victim getting stuck and losing consciousness pretty much immediately, without even being able to get a word in edge-wise. I think even the fastest sedatives still take more time than that -- if only to make it to your heart and up to your brain.
For real, I mean the damn heart hasn't even had time to beat once. But hey, it's TV and that's how it goes in Hollywoodland...
#19
Old 05-03-2011, 02:42 PM
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Dexters Sedatives

Dexter must use an extremely powerful sedative called Etorphine to knock out his victims in such seconds of time.. He also uses a chemical to counter that.. its a chemical that is capable of reversing the effects of the etorphine.. this reversal substance is in a very tiny sachel and sniffed or placed at the nose of the unconscious victim and when inhaled it reverses the effects almost instantly.. Dexter also uses it in an attempt to stay awake in the first episode in season 4 when he kidnaps a dude and takes him to an abandoned boxing gym..
#20
Old 05-03-2011, 03:22 PM
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Quote:
Originally Posted by Shadows503 View Post
Dexter must use an extremely powerful sedative called Etorphine to knock out his victims in such seconds of time.. He also uses a chemical to counter that.. its a chemical that is capable of reversing the effects of the etorphine.. this reversal substance is in a very tiny sachel and sniffed or placed at the nose of the unconscious victim and when inhaled it reverses the effects almost instantly.. Dexter also uses it in an attempt to stay awake in the first episode in season 4 when he kidnaps a dude and takes him to an abandoned boxing gym..
The second post mentioned Etorphin and the second to last post gave a name of a drug used to bring people to consciousness.
#21
Old 05-03-2011, 03:33 PM
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You knew this had to have a page: Instant Sedation

(Danger! Danger! Danger, Will Robinson! TVTropes link!)
#22
Old 05-03-2011, 04:33 PM
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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.

Last edited by Sampiro; 05-03-2011 at 04:34 PM.
#23
Old 05-03-2011, 05:00 PM
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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".
#24
Old 05-03-2011, 05:09 PM
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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?
#25
Old 05-03-2011, 05:09 PM
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Quote:
Originally Posted by Max Torque View Post
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".
How would it work on zombies?
#26
Old 05-03-2011, 05:10 PM
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Quote:
Originally Posted by Moirai View Post
There are lots of fast-acting sedatives- they are just difficult to obtain.

I knew an MD once who would inject himself with pentothal in order to fall asleep. But he had to time it right, because he'd shoot up in the garage then walk/run to bed. At least a few times, he'd miss the dose and pass out half in and half out of the garage.

QtM knew him, I think. maybe he'll verify or correct the pentothal ID...
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?
#27
Old 05-03-2011, 05:15 PM
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Originally Posted by Mr. Excellent View Post
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?
#28
Old 05-03-2011, 05:28 PM
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Quote:
Originally Posted by Max Torque View Post
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".
I was going to say "So is getting hacked up by a serial killer", but I think that's a little too fatal.
#29
Old 05-03-2011, 06:12 PM
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Quote:
Originally Posted by Max Torque View Post
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".
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.
#30
Old 05-03-2011, 07:46 PM
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Quote:
Originally Posted by Max Torque View Post
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".
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>

Quote:
Originally Posted by neutron star View Post
Naloxone (brand name: Narcan) is an opiod receptor competetive antagonist that is strong enough to bring someone from the most blissful heroin high of their life (or an overdose) to screaming in agony from opiate withdrawal (if used on an addict) in the space of two minutes.
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.
#31
Old 05-03-2011, 10:09 PM
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Dexter actually said M99 in one of the episodes.
#32
Old 05-04-2011, 10:29 AM
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Quote:
Originally Posted by Moirai View Post
...I knew an MD once who would inject himself with pentothal in order to fall asleep. But he had to time it right, because he'd shoot up in the garage then walk/run to bed. At least a few times, he'd miss the dose and pass out half in and half out of the garage....
Um... why not just keep a vial and needle in his bedside table?
#33
Old 05-04-2011, 10:45 AM
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Originally Posted by SciFiSam View Post
In one episode he tried to tranq an absolutely enormous man, and it failed.
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.

Quote:
Originally Posted by PetW View Post
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.
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.)
#34
Old 05-04-2011, 11:11 AM
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Originally Posted by cmyk View Post
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?
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...
#35
Old 05-05-2011, 01:40 AM
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The only thing missing from the OP is "Need answer fast".

Last edited by Oslo Ostragoth; 05-05-2011 at 01:44 AM.
#36
Old 05-05-2011, 08:00 AM
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Originally Posted by phungi View Post
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...
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.
#37
Old 05-05-2011, 08:09 AM
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Originally Posted by Elendil's Heir View Post
Um... why not just keep a vial and needle in his bedside table?
He didn't want his family to see him do it, hence the secretiveness.
#38
Old 08-21-2011, 02:51 AM
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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.

Quote:
Originally Posted by Max Torque View Post
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".
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.

Quote:
Originally Posted by phungi View Post
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 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.

Quote:
Originally Posted by AuntiePam View Post
friedo, that fits with the effects of M99:

"M99 (etorphine hydrochloride) was synthesised by Bentley & Hardy (1963) and is chemically related to morphine. When given subcutaneously, M99 is 1,000 to 80,000 times more potent than morphine as an analgesic. Its use for immobilising game animals results largely from its ability to cause catatonia at very low dose levels (for example, the total dose for a rhino may be as low as 5 mg)."

I wonder if Dex gives his victims something else to wake them up after he's taken them to the kill room.

Oh, and one website says that anyone using the drug is required to have an antidote ready to go, in case someone is accidentally scratched by the needle or if it gets on their skin. It sounds like very fast-acting powerful stuff.
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.
#39
Old 08-21-2011, 03:23 AM
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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.

Last edited by tephros; 08-21-2011 at 03:24 AM.
#40
Old 08-21-2011, 12:19 PM
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Quote:
Originally Posted by MsRobyn View Post
He didn't want his family to see him do it, hence the secretiveness.
And how did he explain the occasional "Daddy's napping in the garage again" moments?
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