Comparison of analytical methods in the determination of two venlafaxine fatalities.

Two venlafaxine (Effexor)-related deaths are reported with comparison of results from the analysis of specimens using capillary gas chromatography with a nitrogen-phosphorous detector (GC-NPD) and high-performance liquid chromatography (HPLC) using a UV-vis detector. Blood concentrations in Case 1 were 7.27 micrograms/mL venlafaxine and 5.03 micrograms/mL O-desmethylvenlafaxine, and Case 2 had 89.67 micrograms/mL venlafaxine with 3.44 micrograms/mL of the desmethyl metabolite. A comparison of analytical methods and specimen concentration is presented.

Phencyclidine and violent deaths in St. Louis, Missouri: a survey of medical examiners' cases from 1977 through 1986.

A survey of 104 deaths involving phencyclidine (PCP) occurring from 1981 through 1986 in metropolitan St. Louis, Missouri, is presented. Four black males (22-33 yr) died from fatal PCP intoxication. PCP was detected in an additional 100 deaths: 81 homicides, 13 suicides, and 6 accidental deaths. Seventy-five of these deaths were homicides of Black males (mean age 27 years) typically dying from gunshot wounds, 64 cases. In 50% of deaths where PCP was detected, other drugs were co-administered: ethanol (35%) and cocaine (20%) being the most common mixtures. A dramatic continuous increase in PCP abuse from 1984 through 1986 was demonstrated by drug abuse indicator data: treatment admissions, emergency room episodes, police exhibits, and driving under the influence of PCP arrests. Increased abuse of PCP in St. Louis has been associated with increased medical emergencies and violence against persons.

Drug findings in 'Driving Under the Influence of Drugs' cases: a problem of illicit drug use.

Drug findings in 137 drug positive cases of Driving Under the Influence of Drugs (DUID) occurring in St. Louis, Missouri, U.S.A. from June 1983 through May 1986 are presented. Thirty-two different drugs were detected. A single agent was detected in only 34% (47/137) of cases. The most frequently encountered drugs, expressed as percent of positive cases, were: phencyclidine, 47%; marijuana, 47%; benzodiazepines, 22%; barbiturates, 15%; opiates, 11%; and cocaine, 9%. Most multiple drug cases involved popular illicit drug mixtures, such as cocaine and morphine (speedballs) or phencyclidine on marijuana (whack). All the drivers in this survey had displayed inappropriate or impaired operation of a motor vehicle to the extent that a law enforcement officer had stopped and charged them for DUID. In at least 81% of the drug positive cases, persons impaired in the operation of a motor vehicle from a drug or drugs other than alcohol, were impaired not as the result of side effects of therapeutic drug use, but as the result of deliberate self intoxication with illicit or controlled substances.

Tissue disposition of cocaine in man: a report of five fatal poisonings.

The disposition of cocaine in five cases of fatal poisoning are presented. The highest concentrations of cocaine were found in urine, kidney, spleen, brain, lung and skeletal muscle. Cocaine concentrations in these organs far exceeded those in blood. Cocaine was detected in all other specimens tested including: bile, heart, liver, vitreous and adipose tissue. These results are in agreement with limited, previously reported, tissue data, and indicate that when urine is not available, kidney, spleen, brain and/or lung should be the specimen of choice for cocaine detection.

Chlorprothixene and chlorprothixene-sulfoxide in body fluids from a case of drug overdose.

A case of fatal drug overdose involving chlorprothixene is presented. Chlorprothixene and chlorprothixene sulfoxide (CPT-SO) metabolite concentrations (mg/L) in body fluids as determined by spectrophotofluorometry were: blood, 0.10 and 0.60; bile, 3.9 and 7.0; urine, 0.4 and 3.4; and stomach contents, 340 mg and 25 mg total, respectively. Qualitative identification of chlorprothixene and CPT-SO was by thin layer and gas liquid chromatography and spectrophotofluorometry following alkaline permanganate oxidation.