Toxicological Findings in a Possible Drug-drug Interaction Death: A Case Report
Synergistic effects are the most encountered types of drug-drug interaction in post-mortem toxicology. Concomitant use of fentanyl, tramadol and carbamazepine may increase the risk of severe serotonin toxicity. The decedent was a 32-year-old black man, with a history of severe migraine headaches. He...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | Arabic |
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Naif University Publishing House
2021-02-01
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| Series: | Arab Journal of Forensic Sciences & Forensic Medicine |
| Subjects: | |
| Online Access: | https://journals.nauss.edu.sa/index.php/AJFSFM/article/view/1205 |
| _version_ | 1797265117002334208 |
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| author | Mohammed Y. Albeishy Magbool E. Oraiby Ahmad M. Alamir Ibrahim A. Khardali Farid M. Abualsail Ibraheem Mohammed Attafi |
| author_facet | Mohammed Y. Albeishy Magbool E. Oraiby Ahmad M. Alamir Ibrahim A. Khardali Farid M. Abualsail Ibraheem Mohammed Attafi |
| author_sort | Mohammed Y. Albeishy |
| collection | DOAJ |
| description | Synergistic effects are the most encountered types of drug-drug interaction in post-mortem toxicology. Concomitant use of fentanyl, tramadol and carbamazepine may increase the risk of severe serotonin toxicity. The decedent was a 32-year-old black man, with a history of severe migraine headaches. He died after being administered several drugs to treat the migraine. For fentanyl identification and quantification, samples were extracted using solid phase extraction and analyzed by GC-MS. For carbamazepine and tramadol identification and quantification, samples were extracted by liquid-liquid extraction and analyzed by LC-QTOF. Toxicology showed post-mortem concentrations of fentanyl 0.033, 0.025, 0.005, 0.0127, and 0.005 mg/L; tramadol 0.143, 0.093, 0.043, 0.09, and 0.08 mg/L; carbamazepine 1.6, 1.04, 0.3, 0.83, and 0.18 mg/L in the blood, brain, liver, kidney and stomach, respectively. In this case report, the combination of serotonergic drugs can contribute to synergistic serotonergic effects. Therefore, drug-drug interaction is expected, and the cause of death may be attributed to toxic synergistic drug-drug interaction including fentanyl, tramadol and carbamazepine |
| first_indexed | 2024-04-25T00:39:41Z |
| format | Article |
| id | doaj.art-769530635b6c496881181af91cb488d5 |
| institution | Directory Open Access Journal |
| issn | 1658-6786 1658-6794 |
| language | Arabic |
| last_indexed | 2024-04-25T00:39:41Z |
| publishDate | 2021-02-01 |
| publisher | Naif University Publishing House |
| record_format | Article |
| series | Arab Journal of Forensic Sciences & Forensic Medicine |
| spelling | doaj.art-769530635b6c496881181af91cb488d52024-03-12T12:27:58ZaraNaif University Publishing HouseArab Journal of Forensic Sciences & Forensic Medicine1658-67861658-67942021-02-013112813310.26735/JEZB2564541Toxicological Findings in a Possible Drug-drug Interaction Death: A Case ReportMohammed Y. Albeishy0Magbool E. Oraiby1Ahmad M. Alamir2Ibrahim A. Khardali3Farid M. Abualsail4Ibraheem Mohammed Attafi5https://orcid.org/0000-0001-5801-8500Poison Control & Medical Forensic Chemistry Center, Jazan Health Affairs, Jazan, Saudi Arabia.Poison Control & Medical Forensic Chemistry Center, Jazan Health Affairs, Jazan, Saudi Arabia.Poison Control & Medical Forensic Chemistry Center, Jazan Health Affairs, Jazan, Saudi Arabia.Poison Control & Medical Forensic Chemistry Center, Jazan Health Affairs, Jazan, Saudi Arabia.Poison Control & Medical Forensic Chemistry Center, Jazan Health Affairs, Jazan, Saudi Arabia.Poison Control and Medical Forensic Chemistry Center, General Directorate of Health Affairs, Jazan, Saudi ArabiaSynergistic effects are the most encountered types of drug-drug interaction in post-mortem toxicology. Concomitant use of fentanyl, tramadol and carbamazepine may increase the risk of severe serotonin toxicity. The decedent was a 32-year-old black man, with a history of severe migraine headaches. He died after being administered several drugs to treat the migraine. For fentanyl identification and quantification, samples were extracted using solid phase extraction and analyzed by GC-MS. For carbamazepine and tramadol identification and quantification, samples were extracted by liquid-liquid extraction and analyzed by LC-QTOF. Toxicology showed post-mortem concentrations of fentanyl 0.033, 0.025, 0.005, 0.0127, and 0.005 mg/L; tramadol 0.143, 0.093, 0.043, 0.09, and 0.08 mg/L; carbamazepine 1.6, 1.04, 0.3, 0.83, and 0.18 mg/L in the blood, brain, liver, kidney and stomach, respectively. In this case report, the combination of serotonergic drugs can contribute to synergistic serotonergic effects. Therefore, drug-drug interaction is expected, and the cause of death may be attributed to toxic synergistic drug-drug interaction including fentanyl, tramadol and carbamazepinehttps://journals.nauss.edu.sa/index.php/AJFSFM/article/view/1205forensic sciencepost-mortem toxicologydrug-drug interactionfentanyltramadolcarbamazepine |
| spellingShingle | Mohammed Y. Albeishy Magbool E. Oraiby Ahmad M. Alamir Ibrahim A. Khardali Farid M. Abualsail Ibraheem Mohammed Attafi Toxicological Findings in a Possible Drug-drug Interaction Death: A Case Report Arab Journal of Forensic Sciences & Forensic Medicine forensic science post-mortem toxicology drug-drug interaction fentanyl tramadol carbamazepine |
| title | Toxicological Findings in a Possible Drug-drug Interaction Death: A Case Report |
| title_full | Toxicological Findings in a Possible Drug-drug Interaction Death: A Case Report |
| title_fullStr | Toxicological Findings in a Possible Drug-drug Interaction Death: A Case Report |
| title_full_unstemmed | Toxicological Findings in a Possible Drug-drug Interaction Death: A Case Report |
| title_short | Toxicological Findings in a Possible Drug-drug Interaction Death: A Case Report |
| title_sort | toxicological findings in a possible drug drug interaction death a case report |
| topic | forensic science post-mortem toxicology drug-drug interaction fentanyl tramadol carbamazepine |
| url | https://journals.nauss.edu.sa/index.php/AJFSFM/article/view/1205 |
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