The Use of Z-Drugs to Facilitate Sexual Assault.

Zolpidem, zopiclone, and zaleplon are commonly referred to as the "Z-drugs." The Z-drugs are nonbenzodiazepine hypnotics indicated for the short-term treatment of insomnia. Since becoming widely prescribed as sleep aids in the United States, they are increasingly being detected in a variety of forensic specimens. We present a comprehensive overview of the basic chemistry, pharmacodynamics, and pharmacokinetics of zolpidem, zopiclone, and zaleplon, including their interaction with other prescription drugs and ethanol, findings in drug-facilitated sexual assault (DFSA) casework, and methods of analysis.

Sudden death due to butane inhalation.

Sudden death due to the inhalation of halogenated hydrocarbons is a well-documented phenomenon in the scientific and medical literature. Recently, there has been sporadic information suggesting that nonhalogenated hydrocarbons may cause potentially fatal cardiac arrhythmias. This report documents five sudden deaths due to inhalation of nonhalogenated hydrocarbons: n-butane, isobutane and propane. The hydrocarbons were identified by headspace gas chromatography in blood, brain, and lung tissue. Case histories, toxicological findings and analytical procedures are discussed.

Gas flames, closed spaces, and hypoxia.

The investigation of the deaths of an elderly couple found in a small hotel room that was tightly sealed and heated by an open flame gas heater is presented. Autopsy and toxicologic studies did not reveal a definitive cause of death. Subsequent research and an experiment to duplicate the conditions support the contention that the cause of death was hypoxia due to oxygen depletion by the gas flame.

Postmortem distribution of mexiletine in a fatal overdose.

A case involving a fatal overdose of mexiletine is presented. Quantitation of the drug was accomplished by gas chromatography with a flame-ionization detector. The presence of mexiletine was confirmed by gas chromatography-mass spectrometry. Toxicological analysis revealed the following tissue distribution of mexiletine: heart blood, 44.8 micrograms/mL; femoral blood, 10.0 micrograms/mL; vitreous, 8.6 micrograms/mL; liver, 171.6 micrograms/g; brain, 84.0 micrograms/g; and gastric contents, 1464 mg.

Tissue distribution of ibuprofen in a fatal overdose.

A 26-year-old white man was found dead near his home. The decedent had had a history of ibuprofen overdose and had recently received a physician's order for 800 mg ibuprofen every 4 h for back pain. Postmortem examination was performed and was unrevealing except for heavy lungs (1,140 g combined weight) and a brownish-white granular residue in the stomach. Samples of heart blood, femoral blood, liver, brain, and gastric contents were submitted for toxicological analysis. Qualitative screening detected only the presence of ibuprofen. Quantitation of ibuprofen was performed using reverse-phase high-performance liquid chromatography (HPLC) with ultraviolet detection. The analytical column was an Econosphere C-8 column (150 mm, 4.6 mm I.D.) with 5 microns particle size preceded by a C-8 5 microns guard column. The mobile phase was 46% methanol and 54% 0.2 M acetate buffer at a flow rate of 2 ml/min. Fenoprofen was used as an internal standard at 200 mcg/ml. A linear response (r = 0.99) was achieved over a concentration range of 25-600 mcg/ml. Ibuprofen was identified and quantitated in the following tissues: heart blood (518.0 mcg/ml), femoral blood (348.3 mcg/ml), liver (942.1 mcg/g), brain (283.9 mcg/g), and gastric contents (131 mg total).

Tissue distribution of bupropion in a fatal overdose.

A fatality resulting from the ingestion of bupropion is reported. Quantitation of bupropion and its metabolites was accomplished by gas chromatography. The distribution of bupropion and its metabolites, along with analytical details, is presented.

Tissue distribution of methylenedioxymethamphetamine.

Two cases of death involving methylenedioxymethamphetamine (MDMA) are reported; one case is a fatal acute overdose and the other is a drug-related death. The tissue distribution of MDMA is reported in both cases.

A nortriptyline death with unusually high tissue concentrations.

A 31-year-old male died from a suicidal overdose of nortriptyline. An unusually high heart blood concentration of 86.4 mg/L is reported, along with femoral blood and tissue concentrations.

Fluoxetine overdose: a case report.

A fatality due to the ingestion of fluoxetine and ethanol is reported. Quantitation of the drug and its active normetabolite was accomplished by gas chromatography with a flame ionization detector. Identification of the compounds was performed by gas chromatography/mass spectrometry. Tissue distribution of fluoxetine and norfluoxetine, as well as analytical details, is presented.

Fatality resulting from metoprolol overdose.

A death due to an intentional overdose of metoprolol is described. The drug was quantified by gas chromatography, and identification was confirmed by gas chromatography/mass spectrometry. Metoprolol concentrations in blood, bile, urine, and vitreous humor were 19.8 mg/L, 83.1 mg/L, 1.6 mg/L, and 15.1 mg/L, respectively. A blood ethanol concentration of 0.25 g/100 mL was the only other significant toxicologic finding.

Amoxapine overdose: report of two cases.

Two deaths are described involving amoxapine. Toxicological analysis in Case 1 revealed an amoxapine blood concentration of 5.7 micrograms/mL, and in Case 2, a concentration of 3.2 micrograms/mL. Qualitative analysis of other body fluids were performed.

The in vitro metabolism of aflatoxin Q1 by mouse and rabbit liver preparations.

The investigation of the in vitro metabolism of aflatoxin Q1 by the post-mitochondrial fraction of mouse and rabbit liver is reported. Both animals metabolized this substance at a turnover similar to aflatoxin B1. There was a higher bound fraction and lower aqueous fraction from the metabolism of B1 than from aflatoxin Q1. The aqueous fraction of the metabolisms evidenced the beta-D-glucuronide of aflatoxin Q1. The rabbit metabolism of Q1 was characterized by high levels of chloroform soluble metabolites. In contrast, the mouse metabolism resulted in high glucuronide and bound Q1 metabolite levels.

In vitro metabolism of aflatoxin Q1 by rat liver post-mitochondrial homogenates.

An investigation of the in vitro biotransformation of aflatoxin Q1 by the post-mitochondrial fraction of rat liver is reported. These studies showed a 10 to 25 percent turnover of aflatoxin Q1, with the subsequent formation of five metabolites. A major metabolite was determined to be the beta-D-glucuronide of aflatoxin Q1.

Mineralization of human aortas with coarctation: quantitative electron probe microanalysis.

Aortas with coarctation (isthmus stenosis) are obviously an ideal model to investigate pressure dependent changes of the aorta, as one can compare the proximal region (high pressure) with the distal region (low pressure). 7 aortas of patients aged from 2 months to 54 years were investigated. The concentrations of Na, Mg, P, S, C1, K, and Ca were determined by electronprobe microanalysis. Ca and P are constituent parts of the developing mineral and are mainly discussed. The Ca/P ratio (by weight) is about 0.3 in the unmineralized and about 2 in the mineralized tissue. Mineralization is demonstrated by a parallel increase of Ca, P, and the Ca/P ratio. Enrichments of Ca and P are found above all in a subintimal band. Usually they occur proximally and distally, but are much more pronounced proximally. Even in the aorta of a 2 month old infant enrichments were found proximally, but not distally. Thus mineral deposits occur very early in regions of hypertension. The differences between the proximal and distal region may demonstrate the influence of blood pressure on vascular mineralization. The mineralization starts in small compartments, which increase in size and number in the process of mineralization. Mineralized regions could often be localized by cathodoluminescence. But to demonstrate and localize the initial mineral deposits and to quantify element contents, electronprobe microanalysis became indispensable.

[Electron probe x-ray microanalysis of human aorta with isthmus stenosis]. / Menschliche Aorten mit Isthmusstenose: Elementbestimmungen mit der Elektronenstrahlmikroanalyse.

Aortas with isthmus stenosis (coarctation) can be regarded as a model for those changes of the vessel wall, that depend on blood pressure, as one can compare the proximal region (high pressure) with the distal one (low pressure). The Na, Mg, P, S, Cl, K, and Ca content of the vessel walls of 5 patients (age: 2 months to 34 years) were determined by electron probe microanalysis. We have used cryostat sections and measured the element concentrations from the lumen to the outer media. In this paper we discuss especially the measurements of Ca and P, as the mineral being deposited in the vessel wall, e.g. in arteriosclerosis, contains Ca and P. Up to 18 years Ca and P enrichments are found only in a subintimal band parallel to the lumen. The proximal region of the aorta of a 34 years old patient, however, demonstrated Ca and P enrichments in the whole media with a high peak in the subintimal band. The enrichments are proximally always higher than distally. Only in the distal region of the 2 months old infant no Ca or P enrichments were found, but they appeared proximally. Thus high blood pressure causes an enrichment of Ca and P in a subintimal band very rapidly and promotes the mineralization of the vessel wall. The quantitative electron probe microanalysis demonstrated these pathological alterations.