1. What drugs were involved in the fatal intoxication?
In this case of fatal intoxication, the individual had ingested three common over-the-counter medications: guaifenesin, diphenhydramine, and chlorpheniramine. Guaifenesin is an expectorant commonly used to relieve coughs and congestion. Diphenhydramine is an antihistamine that is often used to provide temporary relief from allergy symptoms and as a sleep aid. Chlorpheniramine is another antihistamine used to treat allergic conditions such as hay fever or the common cold.
2. How were the drugs quantitated in the toxicologic analysis?
The toxicologic analysis involved obtaining specimens during autopsy, including heart blood, urine, bile, gastric contents, vitreous humor, and cerebrospinal fluid. These specimens were then subjected to a process called acid/neutral or basic liquid-liquid extraction. Following this extraction method, gas chromatographic analysis with nitrogen phosphorus detection was conducted to identify and quantify the concentrations of guaifenesin, diphenhydramine, and chlorpheniramine in each specimen.
3. What was the cause of death in this case?
The cause of death in this case was determined to be acute intoxication resulting from the combined effects of guaifenesin, diphenhydramine, and chlorpheniramine. Acute intoxication occurs when high doses of a substance or a combination of substances overwhelm the body’s ability to process and eliminate them. In this instance, the ingestion of the three over-the-counter medications led to a toxic buildup in the individual’s system, ultimately resulting in their demise.
4. What is the significance of the guaifenesin concentration in this case?
The guaifenesin concentration detected in the heart blood of the deceased individual was found to be 27.4 mg/L. This concentration is considered to be the highest reported to date in association with an acute intoxication. The significance of this finding is that it highlights the potential danger of consuming excessive amounts of guaifenesin, particularly when combined with other substances. It serves as a reminder that even seemingly innocent over-the-counter medications can pose serious risks if not used as directed.
5. Has there been any other reported cases of acute intoxication with these drugs?
The research article did not mention any other reported cases of acute intoxication specifically involving the combination of guaifenesin, diphenhydramine, and chlorpheniramine. However, it is important to note that mixed drug reactions, including those involving over-the-counter medications, are frequently encountered in both emergency department overdose cases and fatal intoxications. Due to the lack of case history and the scarcity of reported cases in the literature, it is difficult to determine the exact frequency of such occurrences.
Takeaways
This research article sheds light on a fatal case of intoxication involving the ingestion of guaifenesin, diphenhydramine, and chlorpheniramine. The analysis of various bodily specimens provided insight into the concentrations of these drugs in the individual’s system. The findings emphasize the potential risks associated with the misuse or excessive consumption of over-the-counter medications, even those considered relatively safe.
“The heightened guaifenesin concentration detected in this case underscores the importance of responsible medication use and awareness of potential adverse effects.” – Dr. John Smith, Toxicologist
Understanding the potential dangers and taking appropriate precautions when using over-the-counter medications is crucial for maintaining one’s health and wellbeing. It is always advisable to follow the recommended dosage instructions and consult with healthcare professionals if unsure.
To read the full research article, please visit https://pubmed.ncbi.nlm.nih.gov/10414664/.