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Characterization of pentoxyverine metabolites in urine using GC/MS after intoxication with Silomat cough drops

F Westphal1, Th Junge, L Radünz

  • 1State Bureau of Criminal Investigation Schleswig-Holstein, Section Narcotics/Toxicology, Mühlenweg 166, 24116 Kiel, Germany. dr.-folker.westphal@polizei.landsh.de

Forensic Science International
|April 1, 2011
PubMed

Insights

A young child experienced disorientation and hallucinations after ingesting Silomat cough drops. Gas chromatography-mass spectrometry confirmed pentoxyverine (carbetapentane) and its metabolites in the child's urine, indicating an overdose.

Area of Science:

  • Toxicology
  • Analytical Chemistry
  • Pediatric Medicine

Background:

  • Accidental pediatric ingestions of over-the-counter medications pose significant health risks.
  • Pentoxyverine (carbetapentane) is an antitussive agent found in some cough preparations.

Observation:

  • A toddler presented with acute neurological symptoms including disorientation and hallucinations.
  • The child had recent access to Silomat cough drops, prompting suspicion of intoxication.

Findings:

  • Urine analysis using gas chromatography-mass spectrometry (GC/MS) identified high levels of pentoxyverine and its metabolites.
  • Identified metabolites included hydrolyzed, desalkylated, and ring-hydroxylated forms, confirming pentoxyverine exposure.

Implications:

  • This case highlights the potential for serious adverse effects from pentoxyverine overdose in children.
  • GC/MS is a crucial tool for identifying drug intoxications and characterizing metabolites in clinical toxicology.
  • Awareness of pentoxyverine in cough drops is important for pediatricians and poison control centers.

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