title: An intoxication involving BRON and verapamil.
abstract: A case is presented in which the body of a 19-year-old white male was found in his family's quarters by his mother. An autopsy failed to determine the cause of death, and specimens were sent out for toxicologic analysis. No ethanol or volatile substances were detected in the blood, urine, or vitreous fluid. Comprehensive drug testing of the urine identified chlorpheniramine, dihydrocodeine, methylephedrine, salicylate, and verapamil. The first three drugs listed appear together in an over-the-counter cold medication in Japan, under the trade name BRON. Blood quantitations (in mg/L) were as follows: chlorpheniramine, 2.6; dihydrocodeine, 4.7; methylephedrine, 5.6; salicylate, 150; and verapamil, 6.0. The cause of death was multiple drug intoxication, and the manner of death was suicide.
authors.affiliation: Division of Forensic Toxicology, Armed Forces Institute of Pathology, Washington, D.C. 20306-6000.
authors.forename: B
authors.initials: B
authors.lastname: Levine
authors.forename: R
authors.initials: R
authors.lastname: Jones
authors.forename: K
authors.initials: K
authors.lastname: Klette
authors.forename: M L
authors.initials: ML
authors.lastname: Smith
authors.forename: E
authors.initials: E
authors.lastname: Kilbane
mesh_terms: D000328:Adult; D002110:Caffeine; D002744:Chlorpheniramine / Q000506:poisoning*; D003061:Codeine / Q000031:analogs & derivatives* / Q000506:poisoning; D004338:Drug Combinations; D004809:Ephedrine / Q000031:analogs & derivatives* / Q000506:poisoning; D006801:Humans; D008297:Male; D013405:Suicide; D014700:Verapamil / Q000506:poisoning*
chemical_list: D004338:Drug Combinations; C062969:caffeine, chlorpheniramine, dihydrocodeine, methylephedrine drug combination; D002110:Caffeine; D002744:Chlorpheniramine; D014700:Verapamil; D004809:Ephedrine; D003061:Codeine