Ferslew K E, Hagardorn A N, McCormick W F
Department of Pharmacology, Quillen-Dishner College of Medicine, East Tennessee State University, Johnson City.
J Forensic Sci. 1990 Mar;35(2):477-82.
A case is presented of a fatal drug interaction caused by ingestion of methocarbamol (Robaxin) and ethanol. Methocarbamol is a carbamate derivative used as a muscle relaxant with sedative effects. Therapeutic concentrations of methocarbamol are reported to be 24 to 41 micrograms/mL. Biological fluids were screened for ethanol using the Abbott TDx system and quantitated by gas-liquid chromatography (GLC). Determination of methocarbamol concentrations in biological tissue homogenates and fluids were obtained by colorimetric analysis of diazotized methocarbamol. Blood ethanol concentration was 135 mg/dL (0.135% w/v) and urine ethanol was 249 mg/dL (0.249% w/v). Methocarbamol concentrations were: blood, 257 micrograms/mL; bile, 927 micrograms/L; urine, 255 micrograms/L; gastric, 3.7 g; liver, 459 micrograms/g; and kidney, 83 micrograms/g. The combination of ethanol and carbamates is contraindicated since acute alcohol intoxication combined with carbamate usage can lead to combined central nervous system depression as a result of the interactive sedative-hypnotic properties of the compounds.
本文报告了一例因同时摄入美索巴莫（罗巴克辛）和乙醇导致的致命药物相互作用病例。美索巴莫是一种氨基甲酸盐衍生物，用作具有镇静作用的肌肉松弛剂。据报道，美索巴莫的治疗浓度为24至41微克/毫升。使用雅培TDx系统对生物体液中的乙醇进行筛查，并通过气液色谱法（GLC）进行定量。通过对重氮化美索巴莫的比色分析来测定生物组织匀浆和体液中美索巴莫的浓度。血液乙醇浓度为135毫克/分升（0.135%重量/体积），尿液乙醇浓度为249毫克/分升（0.249%重量/体积）。美索巴莫浓度分别为：血液，257微克/毫升；胆汁，927微克/升；尿液，255微克/升；胃内容物，3.7克；肝脏，459微克/克；肾脏，83微克/克。乙醇和氨基甲酸盐的组合是禁忌的，因为急性酒精中毒与氨基甲酸盐的使用相结合，由于这些化合物具有相互作用的镇静催眠特性，可能导致中枢神经系统联合抑制。
