ABSTRACT
A 36-year old man, having injured himself severely by smashing windows in a rage of fury, was arrested by the police. He died despite resuscitation attempts. The forensic autopsy showed many superficial skin lacerations, bruises and minor brain swelling, but there was no definitive cause of death. Toxicological analysis showed a high concentration of mephedrone in femoral blood (5.1mg/L) and traces of cocaine, MDMA and oxazepam. The remaining dose of mephedrone in the stomach contents was estimated at 113 mg. Tablets that were found in the house of the deceased also contained mephedrone. We attribute this man's death to a fatal oral intake of mephedrone, which probably led to a state of excited delirium. This was aggravated by blood loss from multiple wounds.
Subject(s)
Central Nervous System Stimulants/poisoning , Delirium/chemically induced , Designer Drugs/poisoning , Methamphetamine/analogs & derivatives , Rage , Adult , Brain Edema/pathology , Central Nervous System Stimulants/analysis , Cocaine/blood , Contusions/pathology , Designer Drugs/analysis , Forensic Toxicology , Gastrointestinal Contents/chemistry , Hemorrhage/pathology , Humans , Lacerations/pathology , Male , Methamphetamine/analysis , Methamphetamine/poisoning , Midazolam/blood , N-Methyl-3,4-methylenedioxyamphetamine/blood , Narcotics/blood , Netherlands , Oxazepam/blood , Skin/injuries , Skin/pathologyABSTRACT
AIMS: To measure and compare the concentration-time profiles of oxazepam and oxazepam glucuronide in blood, serum and oral fluid within the scope of roadside testing. METHODS: Biological samples were collected from eight male subjects after ingestion of 15 or 30 mg oxazepam on separate dosing occasions with an interval of 7 days. The concentration-time profiles of oxazepam and oxazepam glucuronide were fitted by using a one-compartment model. RESULTS: For oxazepam and oxazepam glucuronide, the mean oral fluid/blood ratios were 0.05 (range 0.04-0.07) and 0.004 (range 0.002-0.006), respectively. The concentration-time profiles in oral fluid paralleled those in blood. CONCLUSION: After oral administration of therapeutic doses of oxazepam, concentrations in oral fluid are very much lower than those in blood, and those of oxazepam glucuronide are much lower than those of the parent compound. Nevertheless, assay of oral fluid for oxazepam can be used to detect recent ingestion of the drug in drivers suspected of impaired driving performance.
