ABSTRACT
Four postmortem cases are reported in which the analgesic drug tramadol was identified. Tramadol is an alkaline extractable drug and elutes from a HP-5 column without the need for derivatization. Two metabolites of tramadol, N-desmethyl and O-desmethyl tramadol were also identified. Heart blood concentrations of tramadol in the four cases ranged from 0.17 to 4.4 mg/l. Tissue distribution of tramadol in the four cases failed to identify a sequestration site. None of the deaths reported were attributed to tramadol intoxication.
Subject(s)
Analgesics, Opioid/pharmacokinetics , Tramadol/pharmacokinetics , Adult , Aged , Autopsy , Cause of Death , Chromatography, Gas , Female , Humans , Male , Tissue DistributionABSTRACT
In this study, 25 postmortem urine specimens testing positive, for cocaine and ecogonine methyl ester (EME) by full scan electron impact gas chromatography/mass spectrometry, were used to evaluate the stability of EME in refrigerated and frozen conditions. After an initial quantitation (t = 0), these specimens were split and stored at either 4 degrees C or -20 degrees C. At several intervals, over a six month period, the specimens were tested for cocaine and EME. Twenty-two of the frozen specimens were within 20% of their t = 0 EME concentration after 6 months; 19 of the 25 refrigerated specimens showed similar stability. At least 50% of the EME present was detected in all specimens under both storage conditions. In addition, there was no evidence to suggest that EME concentrations increased over time even though decreases in cocaine concentrations were observed over the same time period. This suggests that the presence of EME in urine specimens indicates in vivo conversion of cocaine and, therefore, use of cocaine.
Subject(s)
Cocaine/analogs & derivatives , Cocaine/administration & dosage , Narcotics/urine , Cocaine/metabolism , Cocaine/urine , Cryopreservation , Drug Stability , Forensic Medicine , Humans , Narcotics/administration & dosage , Time FactorsABSTRACT
The two major urinary metabolites of cocaine are benzoylecgonine (BE) and ecgonine methyl ester (EME). The major advantage of BE screening is that many commercial immunoassays are designed to detect BE. On the other hand, EME is more amenable to gas chromatographic screening. To ascertain the merits of screening BE versus EME for identifying cocaine use, 380 consecutive urine specimens presented to the Office of the Chief Medical Examiner-State of Maryland were tested for BE by EMIT (cutoff 0.3 mg/L) and for EME by gas chromatography-nitrogen-phosphorus detection (cutoff 0.05 mg/L). Each presumptive positive was confirmed by gas chromatography-mass spectrometry. One hundred four specimens tested positive for BE or EME. Ninety three specimens were positive for both BE and EME, seven were positive for BE (cutoff 0.05 mg/L) only and four were positive for EME only. BE concentrations ranged from 0.08-386 mg/L while EME concentrations ranged from 0.06-72 mg/L. The BE concentration was greater than or equal to the EME concentration in 73% of the cases. Using BE as a sole screen, 96% of the cases of cocaine use were identified while EME screening identified 93% of the cases.
Subject(s)
Cocaine/analogs & derivatives , Cocaine/pharmacokinetics , Substance Abuse Detection/methods , Chromatography, Gas , Cocaine/urine , Humans , ImmunoassayABSTRACT
A fatality due to the ingestion of bupropion and ethanol is presented. Bupropion and its metabolites were extracted from several tissues and identified using gas chromatography with nitrogenphosphorus and mass spectrometry detection. The concentrations of bupropion, hydroxybupropion and the erythroamino and threoamino alcohol metabolites in heart blood were 4.2, 5.0, 0.6 and 4.6 mg/l, respectively. The heart blood ethanol concentration was 0.27 g/dl. In addition, bupropion was distributed as follows: subclavian blood, 6.2 mg/l; bile, 1.4 mg/l; kidney, 2.4 mg/l; liver, 1.0 mg/kg; stomach contents, 16 mg and urine, 37 mg/l.
