RESUMEN
A reliable and sensitive method was developed for the detection and determination of pentazocine in human solid tissues using liquid chromatography-dynamic fast atom bombardment (FAB) mass spectrometry, combined with a three-step liquid-liquid extraction procedure. Levallorphan tartrate served as an internal standard. The extract was evaporated to dryness and dissolved in the mobile phase, acetonitrile-10 mM ammonium acetate solution (20:80, pH 4.0) containing 0.5% glycerol as FAB matrix. The eluent was pumped at a flow rate of 25 microl/min and split before introduction to FAB mass spectrometer. Quantitative analysis was carried out by means of monitoring quasi-molecular ions with m/z 286 for pentazocine and m/z 284 for levallorphan. The lower limit of detection of pentazocine in each tissue tested was 1 ng/g with scan mode and 0.1 ng/g with SIM mode. Using this method, the concentrations of pentazocine were determined in the tissues of an autopsied individual to perform toxicological evaluation.
Asunto(s)
Cromatografía Liquida/métodos , Pentazocina/análisis , Espectrometría de Masa Bombardeada por Átomos Veloces/métodos , Anciano , Calibración , Femenino , Humanos , Reproducibilidad de los ResultadosRESUMEN
An 11-year-old boy was hospitalized because of severe diarrhea (over 5 L/day). The child survived; however, the diarrhea continued while he was given intravenous fluids and his electrolyte balance was closely supervised. Based on observation of the patient and his family in the hospital, surreptitious administration of a poison by his mother was suspected, and toxicological analysis was carried out on stools from the boy and on medicine administered to him by his mother. Bisacodyl, a cathartic with a direct effect on the colon, was detected in the medicine, and a metabolite of bisacodyl was present in the stool. We devised a sensitive and reliable method to quantitate the bisacodyl metabolite in urine and serum. The sample was incubated with beta-glucuronidase at 37 degrees C for 2 h; bisacodyl metabolite was extracted with tert-butyl methyl ether, then derivatized by methylation, and subjected to gas chromatography-mass spectrometry. Bisphenol A was used as an internal standard. The calibration curve was linear in the concentration range from 2 to 1000 ng/0.2 mL, and the lower limits of detection were 1 ng/0.2 mL for the urine and 2 ng/0.2 mL for the serum. As concentrations of bisacodyl metabolite in the urine and serum of the patient were clearly defined, perhaps such investigations are warranted before extensive clinical therapy is prescribed.
Asunto(s)
Bisacodilo/envenenamiento , Catárticos/envenenamiento , Bisacodilo/metabolismo , Catárticos/metabolismo , Niño , Diarrea/etiología , Humanos , Masculino , Intoxicación/diagnóstico , Valores de Referencia , Sensibilidad y EspecificidadRESUMEN
A simple, rapid and reliable method was devised to determine the levels of enflurane in human tissues, using gas chromatography and gas chromatography-mass spectrometry. 1,4-Dioxane was used as an internal standard (I.S.). Enflurane and the I.S. were extracted from 0.25 g of body tissues using an automatic headspace sampler and 1 ml of headspace gas was injected into the gas chromatograph. Enflurane was analyzed qualitatively by gas chromatography-mass spectrometry and quantitatively by gas chromatography with a flame-ionization detector. The calibration curves in all tissues examined were linear in the concentration range 1-100 microg/0.25 g. The lower limit of detection was 200-300 ng/0.25 g. The accuracy and precision of this method were evaluated at two different concentrations, 1 and 20 microg/0.25 g. The coefficient of variation ranged from 3.4-13.4%. We used this method to determine the presence of enflurane in tissues from an autopsied individual who died suddenly during extirpation of a malignant tumor.
Asunto(s)
Anestésicos por Inhalación/sangre , Enflurano/sangre , Cromatografía de Gases y Espectrometría de Masas/métodos , Ionización de Llama , Humanos , Masculino , Persona de Mediana Edad , Estándares de Referencia , Reproducibilidad de los Resultados , Sensibilidad y EspecificidadRESUMEN
A selective, sensitive, and reliable method was devised to determine concentrations of amitriptyline and its major metabolite, nortriptyline, in human plasma using high-performance liquid chromatography (HPLC) combined with UV and particle beam mass spectrometry (PBMS). Amitriptyline and nortriptyline were effectively extracted in a three-step solvent extraction procedure. Imipramine was used as the internal standard (IS). Amitriptyline, nortriptyline, and the IS were clearly separated by HPLC on a silica column with the mobile phase of acetonitrile-0.1 M ammonium acetate (94:6, v/v). The calibration curves were linear in the concentration range of 10-1000 ng/g for both compounds with UV and PBMS detections. The lower limits of detection were 5 ng/g for amitriptyline and 10 ng/g for nortriptyline with UV detection and 2 ng/g for amitriptyline and 5 ng/g for nortriptyline with PBMS detection. The absolute recoveries were 58% for amitriptyline and 47% for nortriptyline at a concentration of 50 ng/g. This method proved most useful in accurately identifying amitriptyline and nortriptyline in tissues from an autopsied individual.
Asunto(s)
Amitriptilina/sangre , Antidepresivos Tricíclicos/sangre , Nortriptilina/sangre , Acetatos/química , Acetonitrilos/química , Amitriptilina/análisis , Amitriptilina/envenenamiento , Antidepresivos Tricíclicos/análisis , Antidepresivos Tricíclicos/envenenamiento , Autopsia , Cromatografía Líquida de Alta Presión , Humanos , Hígado/química , Espectrometría de Masas , Nortriptilina/análisis , Intoxicación/sangre , Intoxicación/diagnóstico , Estándares de Referencia , Reproducibilidad de los Resultados , Espectrofotometría UltravioletaRESUMEN
The possibility of detecting paraquat in tissues of rabbits buried underground over a 2-year period was examined. Paraquat (1.2 g) was given orally to rabbits, which were sacrificed 1 h after administration. The animals were buried underground, and the skeletal muscles and the bones were collected 3 and 6 months after death, and 3, 6, 12, and 24 months after death, respectively. Paraquat was present in all bone marrow samples, showing a slight decrease in concentration until 12 months. Paraquat was also detected in all skeletal muscle samples, showing almost no change in concentration until 6 months. These results indicate that intoxication with paraquat as well as the degree of poisoning can both be determined from the skeletal muscles and bone marrow of cadavers which have been buried underground for a long period of time even in human cases.
Asunto(s)
Médula Ósea/química , Músculo Esquelético/química , Paraquat/análisis , Cambios Post Mortem , Animales , Cromatografía Líquida de Alta Presión , Medicina Legal , Humanos , Paraquat/farmacocinética , Paraquat/envenenamiento , Conejos , Factores de Tiempo , Distribución TisularRESUMEN
A 71-year-old man was found dead in a car into which exhaust fumes had been introduced. His wife who was in the same car recovered consciousness following hospitalization. She claimed that they had both attempted suicide by taking a large number of sleeping pills. Autopsy revealed no significant external injuries or medical disorders that would have led to the husband's death. The concentrations of alcohol and carbon-monoxide hemoglobin in his whole blood were 0.26 mg/ml and < 10%, respectively. Therefore, poisoning by carbon monoxide from the exhaust fumes was ruled out, and further toxicological examinations were undertaken. Triazolam, pentobarbital, amitriptyline and bromazepam were all detected in the tissues of the victim; whole blood concentrations were 45.60, 386.4, 521.2 and 166.7 ng/g, respectively. Triazolam (7.350 ng/g) and pentobarbital (288.2 ng/g) were also detected in the whole blood of the wife, collected 17 h after admission to hospital. When evaluating these results in the light of existing literature, we concluded that the victim and his wife had indeed attempted suicide by taking triazolam and pentobarbital. However, only the man had died of triazolam poisoning due to its apparently lethal combination with amitriptyline and other psychotropic drugs which had been prescribed to treat his depression.
Asunto(s)
Amitriptilina/envenenamiento , Antidepresivos Tricíclicos/envenenamiento , Hipnóticos y Sedantes/envenenamiento , Triazolam/envenenamiento , Anciano , Amitriptilina/análisis , Amitriptilina/sangre , Antidepresivos Tricíclicos/análisis , Antidepresivos Tricíclicos/sangre , Bromazepam/sangre , Interacciones Farmacológicas , Etanol/sangre , Resultado Fatal , Femenino , Cromatografía de Gases y Espectrometría de Masas , Humanos , Hipnóticos y Sedantes/análisis , Hipnóticos y Sedantes/sangre , Masculino , Pentobarbital/análisis , Pentobarbital/envenenamiento , Psicotrópicos/análisis , Psicotrópicos/sangre , Psicotrópicos/envenenamiento , Intento de Suicidio , Triazolam/análisis , Triazolam/sangreRESUMEN
We developed a simple, sensitive and reliable method for the determination of sulpiride, a specific antipsychotic drug, in human plasma using high-performance liquid chromatography. A structurally related benzamide, tiapride, was used as the internal standard. A Sep-Pak C18 cartridge was used to extract a sample from 1 ml of plasma. The extract was dissolved in methylene chloride, and then back-extracted with 0.01 M hydrochloric acid. The aqueous layer was put on a octadecylsilica column with a mobile phase of 50% acetonitrile in 0.01 M phosphate buffer (pH 3.0). A fluorescence detector with excitation at 300 nm and emission at 365 nm was used for detection. The calibration curve was linear in the concentration range of 10-1500 ng/ml, and the lower limit of detection was 1 ng/ml. We used this method to examine plasma levels of sulpiride in 14 inpatients being treated with sulpiride for 6 months. The determined plasma levels were 70.1-1121.2 ng/ml, and the correlation between daily dose and plasma concentration was positive. This simple, reliable method is expected to be put to good use in forensic and hospital laboratories.
Asunto(s)
Antipsicóticos/sangre , Cromatografía Líquida de Alta Presión/métodos , Sulpirida/sangre , Adulto , Anciano , Relación Dosis-Respuesta a Droga , Humanos , Masculino , Persona de Mediana Edad , Sulpirida/administración & dosificaciónRESUMEN
We developed a sensitive and selective method for determining levels of sultopride, a neuroleptic drug of the substituted benzamide, in human plasma using high-performance liquid chromatography (HPLC) combined with UV detection and particle beam mass spectrometry (PBMS). Sultopride was extracted with tert.-butylmethyl ether using a salting-out technique. Tiapride served as an internal standard (I.S.). Sultopride and I.S. were separated by HPLC on a silica column with a mobile phase of acetonitrile-0.1 M ammonium acetate (94:6, v/v). The calibration curves were linear over the concentration range from 5 to 1000 ng/ml by HPLC with UV detection and from 10 to 1000 ng/ml with PBMS detection. The limit of quantitation was 5 ng/ml with UV detection and 10 ng/ml with PBMS detection. The absolute recovery was 92% and the within-day coefficients of variation were 2.9-7.1% at plasma concentrations from 50 to 500 ng/ml, determined by HPLC with UV detection. Using this method, we measured the plasma concentrations of sultopride with replicate analyses in four hospitalized patients and steady-state plasma levels were determined to be 161.6 +/- 30.8, 321.1 +/- 93.7, 726.5 +/- 143.1 and 1273.6 +/- 211.2 ng/ml, respectively.
Asunto(s)
Antipsicóticos/sangre , Sulpirida/análogos & derivados , Adulto , Anciano , Amisulprida , Cromatografía Líquida de Alta Presión , Humanos , Masculino , Espectrometría de Masas , Persona de Mediana Edad , Sensibilidad y Especificidad , Espectrofotometría Ultravioleta , Sulpirida/sangreRESUMEN
Identification of an electric mark on a body is required for a precise diagnosis of electrocution at the time of forensic autopsy. We applied Elastica-van Gieson (EVG) stain as a means of obtaining the pathomorphological diagnosis of a cutaneous electric mark in relation to a fatal electrocution case. Using EVG stain, the characteristic findings of electric marks, such as elongation of basal-cell nuclei and vacuolation of cells within the epidermis, were clearly observed, while in addition, disarrangement of elastic fibers in the connective tissues within the dermis was also demonstrated. EVG staining was considered to be useful in enabling pathomorphological observations of a cutaneous electric mark to be made.
Asunto(s)
Accidentes de Trabajo , Traumatismos por Electricidad/patología , Células Epidérmicas , Soldadura , Adulto , Tejido Conectivo/patología , Traumatismos por Electricidad/diagnóstico , Resultado Fatal , Medicina Legal , Humanos , Masculino , Coloración y Etiquetado/métodosRESUMEN
Analyses of the hypnotic triazolam from the remains of two human skeletons buried underground for 4 years were made for purposes of confirmation. The bone marrow and mummified muscle were digested with 2 M sodium hydroxide, efficiently extracted using a 3-step solvent extraction procedure, and selectively analyzed by gas chromatography/mass spectrometry with the negative ion chemical ionization mode. Estazolam was the internal standard used. Triazolam was detected in all the samples; the concentrations were 0.36 ng/g in the bone marrow of one victim, and 0.37 and 5.5 ng/g in the bone marrow and mummified muscle of the other victim. This method should prove useful for determination of triazolam in extensively decomposed bodies.
Asunto(s)
Huesos/patología , Medicina Legal/métodos , Hipnóticos y Sedantes/análisis , Triazolam/análisis , Médula Ósea/química , Cromatografía de Gases y Espectrometría de Masas , Humanos , Masculino , Músculo Esquelético/químicaRESUMEN
We examined the distribution of drugs in a 49-year-old brain-dead man. Our objective was to determine the possibility of diagnosing how and at what point the patient became brain dead. The presence of mepivacaine, pentazocine, lidocaine and thiamylal in various tissues, including seven regions of the brain were confirmed, using gas chromatography/mass spectrometry. Tissue-to-blood concentration ratios of mepivacaine, pentazocine and lidocaine in the brain were higher than these ratios in other tissues, while ratios of thiamylal were lower. Therefore, cerebral blood flow was likely to have ceased between the administration of the former drugs and that of the latter drug, in agreement with clinical records. Among seven regions of the brain, the ratios of the former three drugs were high in occipital and parietal lobes, and were low in the cerebellum and medulla oblongata. On the other hand, the ratios of the latter drug were high in the cerebellum and the medulla oblongata. Therefore, cerebral blood flow presumably ceased first in occipital and parietal lobes, and last in the cerebellum and the medulla oblongata. Based on these results, assessment of concentrations of drugs in human tissues, including various regions of brain is useful to determine the time and progression of brain death.
Asunto(s)
Analgésicos Opioides/farmacocinética , Anestésicos Locales/farmacocinética , Autopsia/métodos , Química Encefálica , Muerte Encefálica/patología , Hipnóticos y Sedantes/farmacocinética , Lidocaína/farmacocinética , Mepivacaína/farmacocinética , Pentazocina/farmacocinética , Tiamilal/farmacocinética , Muerte Encefálica/metabolismo , Circulación Cerebrovascular , Cromatografía de Gases y Espectrometría de Masas , Humanos , Masculino , Persona de Mediana Edad , Cambios Post Mortem , Factores de Tiempo , Distribución TisularRESUMEN
In current psychiatric therapy, two or more kinds of antipsychotic drugs are usually prescribed in Japan. However, there are few data on the therapeutic plasma concentrations of antipsychotic drugs or on the correlation between the daily dose and the plasma concentration, in cases where several antipsychotic drugs had been prescribed for each patient. We measured the therapeutic plasma concentrations of 9 antipsychotic drugs in 24 psychiatric inpatients during a 6-month period. They were treated with fixed dosages of antipsychotic drugs. Plasma samples were collected early in the morning once a month, and the concentrations of antipsychotic drugs were determined by gas chromatography with nitrogen phosphorus detection, high-performance liquid chromatography (HPLC) with fluorescence detection and HPLC with UV detection. The plasma levels of chlorpromazine, levomepromazine, thioridazine, haloperidol, bromperidol, zotepine, oxypertine, sulpiride and sultopride were 21.8-92.4, 31.7-156, 101-203, 16.4-56.2, 2.72-11.7, 13.6-84.0, 29.9-80.4, 70.1-1,120 and 35.7-2,990 ng/ml, respectively. A linear correlation between the daily dose and the plasma concentration was noted for sultopride, levomepromazine, sulpiride, haloperidol, chlorpromazine and zotepine.
Asunto(s)
Alcoholismo/sangre , Antipsicóticos/sangre , Esquizofrenia/sangre , Adulto , Anciano , Benzamidas/sangre , Butirofenonas/sangre , Cromatografía de Gases , Cromatografía Líquida de Alta Presión , Dibenzotiepinas/sangre , Femenino , Humanos , Pacientes Internos , Masculino , Persona de Mediana Edad , Fenotiazinas/sangre , Piperazinas/sangreRESUMEN
The detection levels of 12 antipsychotic drugs as ascertained from drug screening were examined in order to use the screening results effectively for treatment of patients or medico-legal examinations in cases of poisoning. Wide-bore capillary gas chromatography with nitrogen phosphorus detection was used for the analysis. The detection limits of drugs in plasma using 3 extraction procedures, single-solvent, 3-step solvent and solid-phase extractions were 50-100 ng/ml, 10-200 ng/ml and 5-50 ng/ml, respectively. The detection limits were compared with blood levels previously reported in the literature. Only 4 drugs were detected at the therapeutic level, thioridazine, floropipamide, sultopride and oxypertine using the single-solvent extraction procedure. Using the 3-step solvent extraction procedure, chlorpromazine, levomepromazine and zotepine in addition to the above 4 drugs were detected. Using the solid-phase extraction procedure, 8 of 12 drugs were able to be detected at the therapeutic level, with the exception of perphenazine, haloperidol, bromperidol and nemonapride. These data were proved to be useful for a rapid forensic diagnosis.
Asunto(s)
Antipsicóticos/sangre , Cromatografía de Gases/métodos , Medicina Legal , Antipsicóticos/envenenamiento , Humanos , Nitrógeno , FósforoRESUMEN
Caffeine concentrations in human tissues of 6 brain death cases as well as 5 non-brain death cases were examined in order to assess the possibility of diagnosing brain death based on an analysis of this compound. Concentrations of caffeine in human tissues were determined using gas chromatography/mass spectrometry. The tissue-to-blood concentration ratios were used to evaluate the distribution pattern in each case. In non-brain death cases, the ratios in all examined tissues were similar, and the values were close to 1 in all tissues except adipose, of which the value was near 0.3. In brain death cases, the ratios in all tissues except brain and adipose were similar to those in non-brain death cases. The ratios in the brain were higher than those of non-brain death cases, in 5 brain death cases, and lower in 1 brain death case to whom blood transfusion was done in a hospital. The ratios in the adipose were slightly higher in brain death cases than those in non-brain death cases. The discorded distribution of caffeine in brain death cases was presumably related to cessation of cerebral blood circulation at the time of brain death. Therefore, comparing caffeine concentrations in the brain with those in the other tissues can be useful for a forensic diagnosis of brain death.
Asunto(s)
Muerte Encefálica/diagnóstico , Cafeína/farmacocinética , Medicina Legal , Adulto , Encéfalo/metabolismo , Muerte Encefálica/metabolismo , Muerte Encefálica/fisiopatología , Circulación Cerebrovascular , Preescolar , Femenino , Cromatografía de Gases y Espectrometría de Masas , Humanos , Masculino , Persona de Mediana Edad , Distribución TisularRESUMEN
In comparison with the hepatocytes obtained from intact rats and rats pretreated with phenobarbital or 3-methylchoranthrene, the amount of isonicotinic acid (INA) formed from isoniazid (INH) increased substantially after incubation at 37 degrees C using the pretreated hepatocytes. This suggests an oxidative pathway for INA formation from INH, apart from hydrolysis. In order to explore the exact mechanism of INA formation in the hepatocytes, an HPLC assay for INA in the presence of INH and acetylisoniazid was developed. In this assay, INA was extracted after the preparation of an ion pair with tetra-n-butylammonium hydroxide, and analysed using an ODS column and a mobile phase consisting of 0.067 M potassium dihydrogenphosphate solution-methanol (96:4, v/v). The method is simple, accurate and especially suitable for INA determination after incubation of INH in isolated rat hepatocytes.
Asunto(s)
Isoniazida/análogos & derivados , Isoniazida/metabolismo , Ácidos Isonicotínicos/metabolismo , Hígado/efectos de los fármacos , Animales , Cromatografía Líquida de Alta Presión , Técnicas In Vitro , Hígado/citología , Hígado/metabolismo , Ratas , Sensibilidad y Especificidad , Espectrofotometría UltravioletaRESUMEN
A reliable and sensitive gas chromatographic-mass spectrometric method was devised to determine the levels of bromazepam in human tissues. Bromazepam was extracted from body tissues using a three-step solvent extraction procedure. N-Desmethyldiazepam served as the internal standard. Selected ion monitoring with m/z 317 for bromazepam and m/z 270 for internal standard was used for quantitation. Calibration curves in all body tissues were linear over the concentration range from 50-500 ng/g. The lower detection limit in body tissues was 2-5 ng/g and the absolute recovery in body tissues was 27.8-68.0%. This method was used to determine the levels of bromazepam in tissues of an autopsied individual who had been prescribed psychotropic drugs and who was found dead in a car.
Asunto(s)
Ansiolíticos/análisis , Bromazepam/análisis , Ansiolíticos/farmacocinética , Química Encefálica , Bromazepam/farmacocinética , Calibración , Cromatografía de Gases y Espectrometría de Masas , Humanos , Indicadores y Reactivos , Hígado/química , Estándares de Referencia , Distribución TisularRESUMEN
An adult male was found dead beneath a pool of sewage in the pump room of a fish market. Autopsy revealed the cause of death to be suffocation after aspirating sewage into the respiratory tract. Since hydrogen sulfide gas was detected in the atmosphere at the scene of the accident, gas poisoning was suspected and toxicological analysis of sulfides in body tissues was performed. The concentrations of sulfides in the blood, lung and kidney were 0.95 mumol@ml, 0.22 and 0.38 mumol/g, respectively. These values were remarkably higher than those in previously reported cases involving exposure to hydrogen sulfide gas. Therefore, oral intake of sulfides was assumed and the distribution of sulfides in tissues following oral administration of sodium sulfide solution was examined by means of animal experiments using rats. The concentration of sulfides in the blood from rats following oral intake was much higher than that seen following gas exposure. Based on these results, we concluded that the victim had been exposed to hydrogen sulfide gas and had then collapse into a pool of sewage containing sulfides. The sulfides which were distributed throughout the body tissues had mainly issued from the alimentary tract prior to death by drowning.
Asunto(s)
Ahogamiento/etiología , Sulfuros/envenenamiento , Adulto , Animales , Medicina Legal/métodos , Humanos , Sulfuro de Hidrógeno/envenenamiento , Masculino , Ratas , Ratas Wistar , Sulfuros/sangre , Sulfuros/farmacocinética , Distribución TisularRESUMEN
1-Acetamino-3-(1-naphthyloxy)-2-propanol (AcNDP) detected in human urine was formed as a metabolite of propranolol (PL) via 1-amino-3-(L-naphthyloxy)-2-propanol (N-desisopropylpropranolol, NDP). The excreted amount of AcNDP was determined by GC-MS using an isotope dilution method. More than 40% of total AcNDP in 24 h urine was detected 10 h after the oral administration of PL to two volunteers, and the total amounts during 24 h urine were at least 1.9-3.9% of the PL dose. As AcNDP is an intermediate metabolite of PL, its urinary amount cannot be determined exactly. Incidentally, AcNDP was chemically stable and was not formed from NDP when acetyl CoA was added to the inactivated hepatocyte system. Thus, the acetylation of NDP, an aliphatic primary amine, was confirmed to be catalyzed by N-acetyltransferase, and interestingly, the acetyl conjugation was inhibited not by sulfamethazine but by p-amino benzoic acid.
Asunto(s)
Acetamidas/metabolismo , Propanolaminas/metabolismo , Propranolol/análogos & derivados , Acetamidas/orina , Adulto , Animales , Cromatografía Líquida de Alta Presión , Femenino , Cromatografía de Gases y Espectrometría de Masas , Humanos , Hígado/citología , Hígado/metabolismo , Masculino , Persona de Mediana Edad , Propanolaminas/orina , Propranolol/administración & dosificación , Propranolol/metabolismo , RatasRESUMEN
A 46-year-old man with schizophrenia, died in hospital. Autopsy revealed numerous facial injuries and the direct cause of death was apparently asphyxia as a large amount of coagulated blood was present in the lower part of the trachea and bronchi. The blood derived from a lacerated wound of the mouth. The question was raised as to why expectoration was impossible and a toxicological analysis was directed to the antipsychotic drugs allegedly prescribed by doctors at the hospital. Using gas chromatography and gas chromatography/mass spectrometry, four different antipsychotic drugs including chlorpromazine, levomepromazine, zotepine and haloperidol were identified in the whole blood and tissues with concentrations being 1.91, 0.75, 0.61 and 0.48 micrograms/g in the blood, respectively. These levels were toxic to the extent that he could not expectorate and blood accumulating in the airway led to asphyxia and death.
Asunto(s)
Antipsicóticos/efectos adversos , Asfixia/inducido químicamente , Medicina Legal , Antipsicóticos/farmacocinética , Resultado Fatal , Cromatografía de Gases y Espectrometría de Masas , Humanos , Masculino , Persona de Mediana Edad , Esquizofrenia/tratamiento farmacológicoRESUMEN
Brain death was diagnosed by analyzing drug distribution in human tissues. Concentrations of diazepam and phenobarbital in human tissues, administered therapeutically to 3 patients in a critical condition, were determined by gas chromatography with a nitrogen phosphorus detector and gas chromatography-mass spectrometry. In 2 patients administered drugs while the brain was functioning, drug concentrations in the brain were high compared with those in the other tissues. In the other patient given the drugs after vital signs of the brain ceased, the level of drugs in the brain was much lower than seen in other tissues. We propose that a forensic diagnosis of patients who are brain dead can be made by comparing the concentrations of drugs in the brain given at the time of critical condition with concentration of these agents in other tissues. When cerebral function ceased can be roughly estimated by the variable distribution patterns of drugs and time of administration of these drugs.