Journal of analytical toxicology
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We report the rapidly increasing finding of fentanyl in medical examiner cases in southwestern Virginia. During the past 3 years, fentanyl cases have increased from 3 in 2000 to 12 in 2002. The first medical examiner case of 2003 was a fentanyl poisoning. ⋯ The age range of the decedents was 16-53 with an average age of 37. Southwestern Virginia is currently a "hot spot" for misuse and abuse of oxycodone and methadone. The rapid rise in the number of fentanyl cases over the past three years, the increasing availability of fentanyl patches, and the large number of case histories indicating misuse or abuse suggest that fentanyl is rapidly becoming an additional desired opioid similar to oxycodone and methadone.
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A rare fatal case of self-poisoning with nitrobenzene following oral ingestion is reported. On presentation to the hospital, severe methemoglobinemia (70%) was observed in an 82-year-old male who had ingested 250 mL of an unknown substance in the previous 24 h. ⋯ We detected that the blood contained 3.2 microg/mL of nitrobenzene. The determination of nitrobenzene was performed using the combination of GC-FID for screening analysis and quantitation and GC-MS for confirmation of the obtained results.
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In Japan, poisonings by the glyphosate (GLYP)-containing herbicide Roundup and the gluphosinate (GLUF)-based herbicide BASTA have been increasing since about 1987. We applied the gas chromatography-mass spectrometry (GC-MS) method of analysis, on which we have already reported in regard to the determination of the blood serum level of GLUF and its metabolite, for the determination of serum and urinary levels of GLYP and its metabolite aminomethyl phosphonic acid (AMPA). ⋯ In extractions for which the Isolute HAX cartridge was employed, the mean recovery rate of GLYP and AMPA added to serum to yield concentrations of 10-0.1 microg/mL (n = 5) was 91.6 +/- 10.6% (or better), whereas that of GLYP and AMPA added to urine to yield concentrations of 100-1.0 microg/mL (n = 10) was 93.3 +/- 6.6% (or better), both of which were good rates. Also, using this method of analysis, the presence of GLYP was identified in the full mass spectra obtained from the serum of a patient who may or may not have ingested Roundup.
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Case Reports Comparative Study
Oxycodone involvement in drug abuse deaths: a DAWN-based classification scheme applied to an oxycodone postmortem database containing over 1000 cases.
An oxycodone postmortem database was created from 1243 solicited cases from Medical Examiner and Coroner (ME/C) offices in 23 states in the United States over the period from August 27, 1999, through January 17, 2002. The request for cases was specific to only those cases in which the ME/C opined that the death involved oxycodone. Each case was evaluated to determine the role of oxycodone and the specific drug product OxyContin tablets in the death. ⋯ A variety of terms were employed in the COD statements to indicate multiple drug involvement such as "polydrug toxicity", "polypharmacy", "multiple drug poisoning", and "polypharmaceutical overdose". The system for death classification employed in this study recognizes the problems inherent in COD attribution when multiple drugs are involved. Use of this new system for reporting mortality data in future studies involving opioids is recommended.
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Comparative Study
A field evaluation of five on-site drug-testing devices.
A field study was performed at two police agencies to evaluate the utility and accuracy of five on-site urine analysis drug-testing devices when used to test driving under the influence (DUI) arrestees. The devices evaluated were AccuSign, Rapid Drug Screen, TesTcup-5, TesTstik, and Triage. Standard workplace screening cut-off concentrations were used and samples were tested for marijuana, cocaine and metabolites, amphetamine(s), opiates, and PCP (except opiates 300 ng/mL). ⋯ Fifty to 90% of the positive amphetamine(s) samples contained MDMA. A similar percentage of the opiate-positive samples contained hydromorphone or hydrocodone. When additional drugs were included in the confirmation testing, it was concluded that the on-site urine analysis drug-testing results were useful in DUI investigations.