Nefopam Hydrochloride: A Fatal Overdose.

Abstract

Nefopam is a non-opiate analgesic commonly used for the treatment of moderate to severe pain. A case of a 37-year-old male who was found dead in the morning is presented. An autopsy was performed and femoral venous blood, heart blood, urine, and vitreous humor were submitted for toxicological analysis. A general drug screen detected the presence of nefopam, caffeine, nicotine, citalopram, gabapentin, amitriptyline, diazepam and paracetamol in cardiac blood. Nefopam was quantitated by high-performance liquid chromatography with diode-array detection. Nefopam was found at the following concentrations: 13.6 mg/L in unpreserved femoral blood; 14.7 mg/L in preserved (fluoride-oxalate) femoral blood; 21.2 mg/L in unpreserved cardiac blood and 4.5 mg/L in preserved vitreous. Citalopram was present at a concentration of 0.7 mg/L (femoral blood) and 0.9 mg/L (cardiac blood). Ethanol analyzed by headspace gas chromatography (GC-FID) was detected in preserved (fluoride-oxalate) vitreous (14 mg/100 mL) and preserved (fluoride-oxalate) urine 50 mg/100 mL. Death was attributed to atherosclerotic coronary artery disease and therapeutic drug toxicity.

• Authors: L Nitin Seetohul, Giorgia De Paoli, Gail Drummond, Peter D Maskell
• Journal: Journal of analytical toxicology (J Anal Toxicol) 2015 Jul-Aug Vol. 39 Issue 6 Pg. 486-9 ISSN: 1945-2403 [Electronic] England
• PMID: 25855761 (Publication Type: Case Reports, Journal Article)
• Copyright: © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: [email protected].

Chemical References

• Analgesics, Non-Narcotic
• Nefopam

Topics

• Adult
• Analgesics, Non-Narcotic (blood, urine)
• Autopsy
• Carotid Artery Diseases (drug therapy, mortality)
• Cause of Death
• Chromatography, Gas
• Chromatography, High Pressure Liquid
• Drug Overdose (blood, mortality, urine)
• Humans
• Male
• Nefopam (blood, urine)
• Suicide