Document Detail


Relation of postmortem blood alcohol and drug concentrations in fatal poisonings involving amitriptyline, propoxyphene and promazine.
MedLine Citation:
PMID:  16138729     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Drugs and alcohol often occur together in fatal poisonings, complicating the process of determining the cause of death. Especially when found in concentrations generally regarded as toxic but not lethal, the question arises whether the combination of sublethal amounts was the likely cause of death. In this study, we examined poisoning deaths involving amitriptyline, propoxyphene and promazine, which are, after benzodiazepines, the most frequently occurring drugs in Finnish alcohol-related poisonings. From the forensic toxicology database, covering the years 1995-2002, we extracted 332 fatal poisonings, calculated median blood alcohol and drug concentrations, constructed concentration-concentration and concentration-response curves and evaluated the significance of the presence of therapeutic amounts of benzodiazepines. Median amitriptyline and propoxyphene concentrations were lower in alcohol-related cases than in clean drug poisonings. Correspondingly, the median blood alcohol concentrations in all drug-related poisonings were 1.5-2.2 mg/g lower than that found in clean alcohol poisonings. Alcohol concentration proved to be a more sensitive indicator of alcohol-drug interaction than drug concentration. This result suggests that when alcohol is present, relatively small overdoses of the studied drugs may result in fatal poisoning. In this context, fatal drug and alcohol concentrations and the issue of determining the most important agent in fatal drug-alcohol intoxications are discussed.
Authors:
A Koski; E Vuori; I Ojanperä
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Human & experimental toxicology     Volume:  24     ISSN:  0960-3271     ISO Abbreviation:  Hum Exp Toxicol     Publication Date:  2005 Aug 
Date Detail:
Created Date:  2005-09-05     Completed Date:  2005-10-04     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9004560     Medline TA:  Hum Exp Toxicol     Country:  England    
Other Details:
Languages:  eng     Pagination:  389-96     Citation Subset:  IM    
Affiliation:
Department of Forensic Medicine, Laboratory of Toxicology, University of Helsinki, Finland. anna.koski@iki.fi
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MeSH Terms
Descriptor/Qualifier:
Amitriptyline / blood,  poisoning*
Dextropropoxyphene / blood,  poisoning*
Drug Interactions
Ethanol / blood*
Finland / epidemiology
Forensic Medicine
Humans
Poisoning / blood,  mortality
Postmortem Changes
Promazine / blood,  poisoning*
Chemical
Reg. No./Substance:
469-62-5/Dextropropoxyphene; 50-48-6/Amitriptyline; 58-40-2/Promazine; 64-17-5/Ethanol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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