Division of Forensic Toxicology, Armed Forces Medical Examiner System, Armed Forces Institute of Pathology, 1413 Research Blvd., Bldg. 102, Rockville, Maryland 20850, USA.
J Anal Toxicol. 2010 Oct;34(8):521-6. doi: 10.1093/jat/34.8.521.
Two cases are reported involving the abuse of extended-release oxymorphone hydrochloride tablets (Opana® ER) in combination with alprazolam (Xanax®). Two juvenile females were discovered unresponsive and hypoxic by a male acquaintance. The trio had reportedly crushed and snorted Opana ER tablets and consumed Xanax for recreational purposes. Emergency personnel were able to stabilize one female. The second female was pronounced dead at the scene. Blood and urine samples from the surviving female were collected at the trauma center between 48 and 96 h post incident. Toxicology results showed the presence of oxymorphone, doxylamine, dextromethorphan, alprazolam, α-hydroxyalprazolam, oxazepam, and temazepam in her urine. No drugs were detected in her blood. Toxicology on the deceased female revealed the presence of 0.13 mg/L oxymorphone and 0.04 mg/L alprazolam in her blood. Gastric contents contained 0.25 and 0.93 mg/L of oxymorphone and alprazolam, respectively. Oxymorphone, alprazolam, and α-hydroxyalprazolam were present in her urine. Quantitative results were achieved by gas chromatography-mass spectrometry monitoring selected ions for the oxime-oxymorphone-trimethylsilyl derivative, alprazolam, and the α-hydroxyalprazolam tert-butyldimethylsilyl derivative. The established linearity ranges for the opiate and benzodiazepine methods were 0.050-3.000 and 0.025-1.000 mg/L, respectively. The cause of death was reported as multiple drug toxicity, and the manner of death was accidental.
报告了两例涉及滥用盐酸羟考酮缓释片（Opana® ER）与阿普唑仑（Xanax®）联合用药的案例。两名年轻女性被一名男性熟人发现失去反应且缺氧。据报道，三人曾将 Opana ER 片剂压碎后吸食，并为了娱乐目的服用了 Xanax。急救人员成功稳定了一名女性。第二名女性在现场被宣布死亡。在创伤中心，对幸存女性的血液和尿液样本进行了采集，采集时间分别为事发后 48 至 96 小时。毒理学结果显示，她的尿液中存在羟考酮、多西拉敏、右美沙芬、阿普唑仑、α-羟基阿普唑仑、奥沙西泮和替马西泮。她的血液中未检测到任何药物。对死者的毒理学检测显示，其血液中存在 0.13 毫克/升羟考酮和 0.04 毫克/升阿普唑仑。胃内容物中分别含有 0.25 和 0.93 毫克/升的羟考酮和阿普唑仑。她的尿液中还存在羟考酮、阿普唑仑和α-羟基阿普唑仑。通过气相色谱-质谱监测肟-羟考酮-三甲基硅烷基衍生物、阿普唑仑和α-羟基阿普唑仑叔丁基二甲基硅烷基衍生物的选定离子，实现了定量结果。阿片类药物和苯二氮䓬类药物方法的建立线性范围分别为 0.050-3.000 和 0.025-1.000 毫克/升。死因报告为多种药物毒性，死亡方式为意外。
