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Forensic Toxicological Implication of an Autopsy Case of Mixed Drug Overdose Involving Clomipramine, Chlorpromazine and Flunitrazepam


Authors: Hiroshi Kinoshita 1;  Minori Nishiguchi 1;  Shogo Kasuda 1;  Motonori Takahashi 1;  Harumi Ouchi 1;  Takako Minami 1;  Kiyoshi Matsui 1;  Takehiko Yamamura 1;  Hiroyuki Motomura 2;  Nao Ohtsu 1;  Shie Yoshida 1;  Nobuyuki Adachi 1;  Takehiko Ohta 1;  Motoo Komeda 1;  Kiyoshi Ameno 3;  Shigeru Hishida 1
Authors‘ workplace: Department of Legal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 66 -8501, Japan 1;  Forensic Science Laboratory, Hyogo Prefectural Police Headquarters, 4-1, Shimoyamate -dori 5-chome, Chuo-ku, Kobe, 650-8510, Japan 2;  Department of Forensic Medicine, Faculty of Medicine, Kagawa University, 1750-1 Miki, Kagawa, 761-0793, Japan 3
Published in: Soud Lék., 53, 2008, No. 3, p. 28-30

Overview

A case of fatal poisoning involving clomipramine, chlorpromazine and flunitrazepam is presented. Quantitative toxicological analysis showed that the concentrations of clomipramine, chlorpromazine and 7-aminoflunitrazepam (a metabolite of flunitrazepam) in the femoral blood were 3.24 μg/ml, 0.36Ķg/ml and 0.61 μg/ml, respectively, and large amounts of drugs were also detected from the stomach contents. We concluded that the cause of death was due to the combined use of clomipramine, chlorpromazine and flunitrazepam.

Key words:
chlorpromazine – clomipramine – flunitrazepam – poisoning


Sources

1. Baselt RC.: Chlorpromazine. In: Baselt RC editor. Disposition of toxic drugs and chemicals in man, (5th ed). Foster City, CA: Chemical Toxicology Institute, 2000, pp. 173-177.

2. Baselt RC.: Clomipramine. In: Baselt RC editor. Disposition of toxic drugs and chemicals in man, (5th ed). Foster City, CA: Chemical Toxicology Institute, 2000, pp. 192-194.

3. Baselt RC.: Flunitrazepam. In: Baselt RC editor. Disposition of toxic drugs and chemicals in man, (5th ed). Foster City, CA: Chemical Toxicology Institute, 2000, pp. 360-362.

4. Drummer OH, Syrjanen ML, Cordner SM.: Deaths involving the benzodiazepine flunitrazepam. Am J Forensic Med Pathol 1993; 14: 238-243.

5. Drummer OH, Odell M.: Benzodiazepines and related drugs. In The forensic pharmacology of drug of abuse. London: Arnold, 2001, pp. 103-175.

6. Frommer DA, Kulig KW, Marx JA, Rumack B.: Tricyclic antidepressant overdose. JAMA 1987; 257: 521-526.

7. Jones GR, Pounder DJ.: Site dependence of drug concentrations in postmortem blood – a case study. J Anal Toxicol 1987; 11: 186-190.

8. Kinoshita H, Taniguchi T, Kubota A, Nishiguchi M, Ouchi H, Minami T, Utsumi T, Motomura H, Nagasaki Y, Ameno K, Hishida S.: An autopsy case of imipramine poisoning. Am J Forensic Med Pathol 2005; 26: 271-274.

9. Moriya F, Hashimoto Y.: Redistribution of basic drugs into cardiac blood from surrounding tissues during early-stages postmortem. J Forensic Sci 1999; 44: 10-16.

10. Peters MD II, Davis SK, Austin LS.: Clomipramine: an antiobsessional tricyclic antidepressant. Clin Pharm 1990; 9: 165-178.

11. Pounder DJ, Jones GR.: Post-mortem drug redistribution – a toxicological nightmare. Forensic Sci Int 1990; 45: 253-263.

12. Pounder DJ, Fuke C, Cox DE, Smith D, Kuroda N.: Postmortem diffusion of drugs from gastric residue an experimental study. Am J Forensic Med Pathol 1996; 17: 1-7.

13. Robertson MD, Drummer OH.: Postmortem drug metabolism by bacteria. J Forensic Sci 1995; 40: 382-386.

14. Schulz M, Schmoldt A.: Therapeutic and toxic blood concentrations of more than 800 drugs and other xenobiotics. Pharmazie 2003; 58: 447-474.

15. Shinohara T, Ijiri I, Fuke C, Kiriu T, Ameno K.: Studies on ethanol absorption from the intestine- blood ethanol and acetaldehyde concentrations in the various vessels. Arukoru Kenkyuto Yakubutsu Ison. 1992; 27: 71-80.

16. Winek CL, Wahba WW, Winek CL Jr, Balzer TW.: Drug and chemical blood-level data 2001. Forensic Sci Int 2001; 122: 107-123.

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Anatomical pathology Forensic medical examiner Toxicology
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