title: Fatality due to ingestion of tramadol alone.
abstract: A rare case of a fatal intoxication in an adult with tramadol alone is reported. In the peripheral blood, tramadol was measured in a concentration of 9.6 mg/l exceeded at least 30-times the normal therapeutic range of 0.1-0.3 mg/l. The concentration of tramadol in liver and kidney, in relation to blood, failed to suggest a major sequestration of drug in either specimen which is consistent with the volume of distribution of 3 l/kg. The concentration of tramadol in the heart and peripheral blood specimens did not suggest a major difference (ratio of 1.36). Similar to morphine tramadol was accumulated significantly in the bile.
authors.affiliation: Institute of Legal Medicine, Rheinische Friedrich-Wilhelms-University, Stiftsplatz 12, 53111, Bonn, Germany. f.musshoff@uni-bonn.de
authors.forename: F
authors.initials: F
authors.lastname: Musshoff
authors.forename: B
authors.initials: B
authors.lastname: Madea
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000032:analysis / Q000378:metabolism / Q000506:poisoning*; D001344:Autopsy / Q000379:methods; D002423:Cause of Death; D002851:Chromatography, High Pressure Liquid; D062787:Drug Overdose; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D007668:Kidney / Q000737:chemistry; D008099:Liver / Q000737:chemistry; D008297:Male; D009206:Myocardium / Q000737:chemistry; D013405:Suicide; D014018:Tissue Distribution; D014147:Tramadol / Q000032:analysis / Q000378:metabolism / Q000506:poisoning*
chemical_list: D000701:Analgesics, Opioid; D014147:Tramadol