Disposition of tilidine in a fatal poisoning in man.
A fatal intoxication due to the ingestion of tilidine, a narcotic analgesic, in conjunction with ethanol, is described. Tilidine and its two active metabolites, nortilidine and bisnortilidine, were identified and quantitated in the biological fluids and tissues by thin-layer chromatography (TLC), gas-liquid chromatography with sensitive nitrogen-phosphorus detection (GLC/NPD) and gas-liquid chromatography with mass spectrometric detection (GC/MS). The toxicological results are compared with previously reported 14C-tilidine tissue distributions in rats following oral administration and limited tissue data in a previously reported human fatality. In the present case, the death was attributed to the combined central nervous system-depressing effects of ethanol and tilidine.
D000328:Adult; D002849:Chromatography, Gas; D002855:Chromatography, Thin Layer; D003509:Cyclohexanecarboxylic Acids / Q000506:poisoning*; D004357:Drug Synergism; D000431:Ethanol / Q000009:adverse effects; D006801:Humans; D008297:Male; D013993:Tilidine / Q000378:metabolism / Q000506:poisoning*
D003509:Cyclohexanecarboxylic Acids; D000431:Ethanol; D013993:Tilidine