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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
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.
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.
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