Chaturvedi A K, Rao N G, Baird J R
Office of the State Toxicologist, North Dakota State University College of Pharmacy, Fargo 58105.
J Anal Toxicol. 1990 Nov-Dec;14(6):385-7. doi: 10.1093/jat/14.6.385.
A fatality resulting from the self-administration of fentanyl is described. The decreased was a health care professional with a known history of drug abuse. At the scene, a syringe partly filled with red fluid was found. Pathological findings disclosed pulmonary congestion, hemorrhage, and aspiration of gastric contents and passive congestion in the liver and kidneys. Initial drug screening revealed the presence of fentanyl in the fluid from the syringe and diazepam/oxazepam in the urine. Fentanyl, diazepam, nordiazepam, and oxazepam in the submitted samples were simultaneously quantitated using a gas chromatograph equipped with a nitrogen-phosphorus detector. The fentanyl concentrations (micrograms/L or micrograms/kg) in serum, blood, urine, bile, liver, kidney, brain, lung, and stomach tissue were 17.7, 27.5, 92.7, 58.2, 77.5, 41.5, 30.2, 83.4, and 31.6, respectively. The tissue levels of diazepam and its metabolites were lower than the reported lethal concentrations. The fentanyl concentration in the syringe contents was 2,800 micrograms/L. The toxicological findings and circumstantial evidence of the case indicate that the death resulted primarily from fentanyl overdose.
描述了一例因自行注射芬太尼导致的死亡案例。死者是一名有药物滥用史的医护人员。在现场发现了一支装有部分红色液体的注射器。病理检查结果显示肺部充血、出血、胃内容物吸入以及肝肾被动充血。初步药物筛查显示注射器内液体中存在芬太尼，尿液中存在地西泮/奥沙西泮。使用配备氮磷检测器的气相色谱仪对送检样本中的芬太尼、地西泮、去甲地西泮和奥沙西泮进行同时定量。血清、血液、尿液、胆汁、肝脏、肾脏、大脑、肺和胃组织中的芬太尼浓度（微克/升或微克/千克）分别为17.7、27.5、92.7、58.2、77.5、41.5、30.2、83.4和31.6。地西泮及其代谢物的组织水平低于报告的致死浓度。注射器内液体中的芬太尼浓度为2800微克/升。该病例的毒理学检查结果和间接证据表明，死亡主要是由芬太尼过量所致。
