一例涉及氯巴占、甲丙氨酯和氯氮卓的致死案例中氯巴占和去甲氯巴占的血药浓度

Blood concentrations of clobazam and norclobazam in a lethal case involving clobazam, meprobamate and clorazepate.

作者信息

Pok Phak-Rop Pos, Mauras Michel, De Saint Léger Marie-Noëlle, Kuhlmann Erika, Charpenel-Durat Catherine, Navarette Claudie, Duval Marie-Laure, De Meo Pierre

机构信息

INPS, Laboratoire de Police Scientifique de Marseille, Section Toxicologie, 97, Boulevard Camille Flammarion, BP30, 13245 Marseille, Cedex 04, France.

出版信息

Leg Med (Tokyo). 2010 Nov;12(6):300-4. doi: 10.1016/j.legalmed.2010.08.002. Epub 2010 Sep 25.

DOI:10.1016/j.legalmed.2010.08.002

PMID:20870445

Abstract

Clobazam is a benzodiazepine with anti-anxiety and anticonvulsant properties marketed in several countries. Norclobazam, a metabolite of clobazam, has similar pharmacological activity but weaker sedative and tranquilizing effect. The two drugs were detected by GC-MS and determined by HPLC-DAD in the samples from a postmortem case. The femoral blood concentrations of clobazam and norclobazam were 0.72 and 36 μg/mL, respectively. The concentration of the active norclobazam was very high. The sum of both clobazam and norclobazam blood concentration (36.72 μg/mL) was clearly toxic, but was not necessarily fatal. Other associated drugs concentrations were within their therapeutic ranges. Interactions due to drug association were discussed.

摘要

氯巴占是一种具有抗焦虑和抗惊厥特性的苯二氮䓬类药物，在多个国家上市。氯巴占的代谢产物去甲氯巴占具有相似的药理活性，但镇静和安定作用较弱。在一例尸检病例的样本中，通过气相色谱-质谱联用仪（GC-MS）检测到了这两种药物，并采用高效液相色谱-二极管阵列检测器（HPLC-DAD）进行测定。氯巴占和去甲氯巴占在股静脉血中的浓度分别为0.72μg/mL和36μg/mL。活性代谢产物去甲氯巴占的浓度非常高。氯巴占和去甲氯巴占的血药浓度总和（36.72μg/mL）明显达到中毒水平，但不一定致命。其他相关药物的浓度在治疗范围内。文中讨论了药物联用引起的相互作用。