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Fatal cold medication intoxication in an infant
Diane M Boland1, Joseph Rein, Emma O Lew
1Miami-Dade Medical Examiner Department, Toxicology Laboratory, 1851 NW 10th Avenue, Miami, Florida 33136, USA.
Journal of Analytical Toxicology
|November 11, 2003
Summary
Toxicological analysis revealed elevated levels of pseudoephedrine, brompheniramine, and dextromethorphan in an infant fatality. These drug concentrations in blood, liver, and a baby bottle suggest potential overdose contributing to the death.
Area of Science:
- Forensic Toxicology
- Pediatric Toxicology
- Pharmacology
Background:
- Infant fatalities require thorough toxicological investigation to determine contributing factors.
- Common over-the-counter medications contain multiple active ingredients that can pose risks, especially to infants.
Observation:
- A case involving an infant fatality is presented, with a focus on the toxicological findings.
- Analysis included postmortem blood and liver specimens, as well as a baby bottle used for administration.
Findings:
- Brompheniramine and dextromethorphan were quantified in blood (0.40 mg/L, 0.50 mg/L) and liver (0.16 mg/kg, 0.57 mg/kg).
- Pseudoephedrine concentrations were measured at 14.4 mg/L in blood and 16 mg/kg in the liver.
- Significant amounts of all three drugs (brompheniramine, dextromethorphan, pseudoephedrine) were detected in the baby bottle.
Implications:
- The presence of these drug concentrations in postmortem samples and the baby bottle warrants further investigation into potential overdose.
- This case highlights the critical importance of accurate dosing and monitoring of medications containing pseudoephedrine, brompheniramine, and dextromethorphan in infants.
- Forensic toxicological analysis is crucial for understanding the role of xenobiotics in unexplained infant deaths.