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Citation |
Solarino B, Rießelmann B, Buschmann CT, Tsokos M. Forensic Sci. Int. 2010; 194(1-3): e17-9. |
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Affiliation |
Institute of Legal Medicine and Forensic Sciences, University Medical Centre Charite, University of Berlin, Turmstr. 21, Building L, 10559 Berlin, Germany; Section of Legal Medicine, Department of Internal Medicine and Public Medicine, University of Bari. |
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Copyright |
(Copyright © 2010, Elsevier Publishing) |
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DOI |
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PMID |
19850423 |
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Abstract |
A fatal case of multidrug poisoning by tramadol and nicotine is reported. Tramadol is a centrally acting analgesic used in the treatment of moderate to severe acute or chronic pain. Nicotine, a lipid-soluble alkaloid, is one of the most readily available drugs in modern society. A 46-year-old man was found dead in his bed, and a suicide note was discovered near the body. He had 25 transdermal nicotine patches attached to his thorax and abdomen. Two half emptied bottles were found on the bedside table; the toxicological examination revealed that they contained tobacco and nicotine as well as other drugs such as diphenhydramine. At autopsy, areas of fresh and old myocardial infarction as well as diffuse pulmonary congestion and edema were present. The tramadol concentration was 6.6mug/mL in femoral venous blood, while levels of nicotine and its primary metabolite cotinine were determined to be 0.6 and 2.0mug/mL in femoral venous blood. Based on these results, we determined the cause of death to be cardiorespiratory failure induced by the additive effects of tramadol and nicotine shortly after consumption. Language: en |