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Related Concept Videos

Pharmaceutical Poisoning: Treatment Strategies01:26

Pharmaceutical Poisoning: Treatment Strategies

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Treatment strategies for poisoning are a critical aspect of emergency medicine, focusing on preventing the absorption of toxins and enhancing their elimination. When a poisoning incident occurs, the first response is to halt exposure and decontaminate the patient, particularly through gastrointestinal (GI) methods if the poison was ingested.Gastrointestinal Decontamination Techniques:Activated charcoal is the cornerstone of GI decontamination. It works through adsorption, binding the toxin to...
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Pharmaceutical Poisoning: Potential Scenarios01:26

Pharmaceutical Poisoning: Potential Scenarios

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Pharmaceutical poisoning can occur through various channels, impacting an estimated 2 million hospitalized patients in the U.S. annually with serious adverse drug responses. These scenarios encompass both therapeutic uses, such as drug toxicity, where even standard dosages can lead to severe central nervous system depression, and non-therapeutic exposures, including accidental ingestion by children, and environmental and occupational exposures.Unintentional poisonings often involve exploratory...
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Toxidromes: Clinical Features01:30

Toxidromes: Clinical Features

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Toxidromes are specific patterns of symptoms resulting from toxic substance exposure. They help in the identification and treatment of poisoning. The symptoms of each toxidrome group indicate poisoning by a certain class of chemicals or drugs.1. Sympathomimetic: Stimulates the sympathetic nervous system. Symptoms include agitation, increased heart rate (HR), blood pressure (BP), respiratory rate (RR), temperature, and pupil size. Drugs like cocaine and amphetamines, along with tremors and...
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Drug Toxicity: Dose-Dependent Reactions01:24

Drug Toxicity: Dose-Dependent Reactions

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Drug toxicities can be stratified into pharmacological, pathological, or genotoxic based on their mechanisms. The incidence and severity of these toxicities generally increase with the drug's concentration in the body and exposure time.Pharmacological toxicity is evident when the therapeutic effects of drugs overshoot into adverse reactions in a predictable, dose-dependent manner. Central nervous system (CNS) depression from barbiturates is a classic example, with effects escalating from...
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Opioid Analgesics: Synthetic and Semisynthetic Opioids01:15

Opioid Analgesics: Synthetic and Semisynthetic Opioids

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Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
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Drug Toxicity: Overview01:00

Drug Toxicity: Overview

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Drug toxicity quantifies the harm a compound causes to an organism, varying by dose and potentially impacting whole systems or specific organs like the liver. Toxic reactions may arise from venomous insect or spider bites, with effects ranging from mild symptoms to severe outcomes such as brain damage or death. Common forms of acute poisoning include ethanol intoxication and overdose of pain or fever medications, with substances like GHB and heroin being particularly lethal at doses close to...
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Related Experiment Videos

Nefopam Hydrochloride: A Fatal Overdose.

L Nitin Seetohul1, Giorgia De Paoli2, Gail Drummond2

  • 1Centre for Forensic and Legal Medicine, University of Dundee, Dundee DD1 4HN, UK Present address: School of Science and Technology, Nottingham Trent University, Nottingham, UK nitin.seetohul@ntu.ac.uk.

Journal of Analytical Toxicology
|April 10, 2015
PubMed
Summary

This case report details the autopsy findings of a male whose death was linked to atherosclerotic coronary artery disease and therapeutic drug toxicity, including elevated nefopam levels.

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Area of Science:

  • Forensic Toxicology
  • Clinical Pharmacology

Background:

  • Nefopam is a non-opiate analgesic used for moderate to severe pain.
  • Understanding the toxicological profile of nefopam in post-mortem cases is crucial.

Observation:

  • A 37-year-old male was found deceased, with autopsy revealing multiple substances in toxicological analysis.
  • Nefopam was detected at concentrations of 13.6-21.2 mg/L in various blood samples.
  • Citalopram, ethanol, caffeine, nicotine, gabapentin, amitriptyline, diazepam, and paracetamol were also identified.

Findings:

  • High-performance liquid chromatography (HPLC) quantified nefopam levels.
  • Gas chromatography (GC-FID) detected ethanol.
  • The cause of death was determined to be atherosclerotic coronary artery disease and therapeutic drug toxicity.

Implications:

  • This case highlights the importance of comprehensive toxicological screening in post-mortem examinations.
  • Quantification of nefopam and co-administered drugs is essential for determining toxicity.
  • Findings contribute to the understanding of nefopam's role in drug-related fatalities.