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因静脉内自行注射托拉朵尔继发过敏性休克死亡:一例病例报告及文献复习

Death due to anaphylactic shock secondary to intravenous self-injection of Toradol: a case report and review of the literature.

作者信息

Oliva Antonio, De Giorgio Fabio, Arena Vincenzo, Fucci Nadia, Pascali Vincenzo L, Navarra Pierluigi

机构信息

Institute of Forensic Medicine, Catholic University, School of Medicine, Rome, Italy.

出版信息

Clin Toxicol (Phila). 2007 Sep;45(6):709-13. doi: 10.1080/15563650701397076.

Abstract

A fatality due to the intravenous self-injection of Ketorolac (Toradol) is reported. Ketorolac is a nonsteroidal anti-inflammatory drug (NSAID) with marked analgesic activity. There is limited information of fatalities attributed to ketorolac toxicity. Here we report the case of a 53-year-old woman with a medical history of depression that was found deceased at home with no evidence of trauma or injuries. Near the body, a syringe and three empty vials (30 mg) of Toradol were found. A fresh needle mark on the right arm was noticed. Toxicological analyses were performed using a gas chromatography-mass spectrometry (GC/MS) technique. The estimated ketorolac concentration in the blood was 8 mug/ml; urine and gastric content were negative for this compound. Based on the autopsy, histologic findings and toxicological results of anaphylactic shock associated with ketorolac self-administration was assumed to be the underlying pathophysiological mechanism of death and the manner, suicide.

摘要

据报道,有一例因静脉注射酮咯酸(托拉朵)导致死亡的案例。酮咯酸是一种具有显著镇痛活性的非甾体抗炎药(NSAID)。关于酮咯酸毒性导致死亡的信息有限。在此,我们报告一例53岁女性,有抑郁症病史,被发现死于家中,无外伤或损伤迹象。在尸体旁发现一支注射器和三瓶空的(30毫克)托拉朵药瓶。右臂有一处新鲜的针眼痕迹。使用气相色谱 - 质谱联用(GC/MS)技术进行了毒理学分析。血液中酮咯酸的估计浓度为8微克/毫升;尿液和胃内容物中该化合物呈阴性。根据尸检、组织学检查结果和毒理学结果,推测与自行注射酮咯酸相关的过敏性休克是潜在的死亡病理生理机制,死亡方式为自杀。

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