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Related Experiment Videos

A dextromoramide-related fatality.

E Brewer1

  • 1New York State Police Crime Laboratory, Albany.

Journal of Forensic Sciences
|March 1, 1990
PubMed
Summary
This summary is machine-generated.

A man experienced a heart attack due to a combination of dextromoramide, methadone, and lidocaine. Serum analysis confirmed these drug levels, with no alcohol detected.

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Area of Science:

  • Toxicology
  • Cardiology
  • Forensic Chemistry

Background:

  • Drug-induced cardiovascular events are a significant concern in emergency medicine.
  • Accurate identification and quantification of substances in serum are crucial for patient management and forensic analysis.

Observation:

  • A 38-year-old male presented with acute myocardial infarction.
  • The patient was found unresponsive in his vehicle.
  • Initial assessment suggested a potential toxicological etiology.

Findings:

  • Serum analysis using capillary gas chromatography and mass spectrometry detected dextromoramide (Palfium), methadone, and lidocaine.
  • Quantified serum concentrations were 1.9 µg/mL for dextromoramide, 0.4 µg/mL for methadone, and 0.4 µg/mL for lidocaine.

Related Experiment Videos

  • Headspace gas chromatography confirmed the absence of alcohol in the serum.

    • Implications:

    • This case highlights the potential cardiotoxicity of combined opioid and local anesthetic use.
    • The findings underscore the importance of comprehensive toxicological screening in cases of unexplained myocardial infarction.
    • Accurate drug quantification is vital for understanding the contribution of specific substances to clinical outcomes.