TY  - JOUR
PY  - 2013//
TI  - A suicidal poisoning due to tramadol. A metabolic approach to death investigation
JO  - Journal of forensic and legal medicine
A1  - Barbera, Nunziata
A1  - Fisichella, Marco
A1  - Bosco, Andrea
A1  - Indorato, Francesca
A1  - Spadaro, Giorgio
A1  - Romano, Guido
SP  - 555
EP  - 558
VL  - 20
IS  - 5
N2  - 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.<p />  <p>Language: en</p>
LA  - en
SN  - 1752-928X
UR  - http://dx.doi.org/10.1016/j.jflm.2013.03.006
ID  - ref1
ER  -