Case Study: Distribution and Redistribution of Levomepromazine and its Metabolites in a Fatal Poisoning

Abstract

The subject of the study is a fatal poisoning with levomepromazine. A toxicological investigation carried out by means of the liquid chromatographic method with mass detection (LC/MS) revealed levomepromazine and its 24 metabolites in postmortem specimens in various concentrations depending on the specimen tested. The study was undertaken not only for judicial evidence, but also to investigate whether any changes occur in the concentrations of xenobiotics found in blood during the postmortem interval. The investigation confirmed such differences in xenobiotic concentrations, proving tha~the passive diffusion of xenobiotics in a body takes place. RESUMECette etude presente un cas d'intoxication fatale SI la levomepromazine;les analyses toxicologiques effectuees par chromatographie Iiquide-spectrometrie de masse (CUSM) ont permis de demontrer la presence de levomepromazine et 24 de ses metabolites dans plusieurs prelevements biologiques postmortem SI diverses concentrations. Cette etude a ete faite autant pour recueillir certains elements de preuve que pour etudier les changements dans les concentrations sanguines de certains xenobiotiques durant la perlode postmortem. Le resultat de cette etude nous a permis de confirmer ces differences dans les concentrations sanguines postmortem prouvant ainsi leur diffusion passive dans I'organisme.

Determination of oxcarbazepine and its metabolites in postmortem blood and hair by means of liquid chromatography with mass detection (HPLC/APCI/MS)

“…In documented fatal poisonings with levomepromazine, the blood of victims showed the precursor concentration values as ranging between 0.8 and 8 g/g [17][18][19]. The case study included additionally distribution and redistribution of levomepromazine and its metabolites in a fatal poisoning was a subject of our previous examination [19].…”

Moja przygoda z toksykologią i medycyną sądową

“…Realizacja nowoczesnego programu naukowego z użyciem techniki LC/MS i GC/MS znajduje potwierdzenie w publikacjach dotyczących oznaczania leków i narkotyków, w tym uwzględniających interakcje [41][42][43] czy procesy redystrybucji pośmiertnej [44,45]. Celowe opracowania analityczne dotyczyły ponadto propozycji szybkich metod diagnozujących zatrucia pankuronium [46], chlorfenoksyaminą [47], kwasem walproinowym [48] czy chlorochiną [49], nifedypiną i acebutolem [50].…”