A suicidal poisoning due to tramadol. A metabolic approach to death investigation
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- 作者：Nunziata Barbera ; Marco Fisichella ; Andrea Bosco ; Francesca Indorato ; Giorgio Spadaro ; Guido Romano
- 关键词：Tramadol ; Postmortem ; Metabolic ratio ; O-desmethyltramadol ; N-desmethyltramadol
- 刊名：Journal of Forensic and Legal Medicine
- 出版年：2013
- 出版时间：July, 2013
- 年：2013
- 卷：20
- 期：5
- 页码：555-558
- 全文大小：181 K
文摘
Tramadol is a synthetic opioid, widely used for post-surgical and chronic pain. Lethal overdose due only to tramadol is not common; more often the poisoning is due to tramadol in combination with other substances.
Reported is a suicidal case of lethal tramadol poisoning in a 48-year-old woman. Tramadol and its metabolites O-desmethyltramadol (M1), N-desmethyltramadol (M2), N,N-didesmethyltramadol (M3), N,O-didesmethyltramadol (M5) were detected by GC/MS in biological fluids (femoral blood, bile, urine, gastric content) and viscera (brain, lung, liver and kidney). The tramadol concentration in femoral blood was 61.83?mcg/ml which is approximately 30 times higher than that believed to be lethal.
According with other Authors, a preferential formation of M1 over M2 (M1/M2 ratio >1) is indicative of acute death, while M1/M2 ratio <1 suggests that death occurred after a longer time lapse from ingestion.