title: Meptazinol and ethanol: a fatal intoxication.
abstract: Meptazinol (Meptid(®)) is an analgesic drug that is used to treat mild to moderate pain including postoperative pain, obstetrical pain, and the pain of renal colic. This case reports a death due to the combined effects of meptazinol and alcohol in a man with significant heart disease and alcoholic liver disease. A 57-year-old male was found unresponsive in his bed at home with empty blister packets of meptazinol around him. A general drug screen detected the presence of meptazinol, and caffeine and metabolites, in cardiac blood. Analysis, both quantitative (HPLC-DAD) and qualitative (HPLC-DAD, LC-MS), of meptazinol was carried out. Meptazinol was found at the following concentrations: 15.5 mg/L in unpreserved femoral blood; 18.6 mg/L in preserved (fluoride-oxalate) femoral blood; 52.1 mg/L in unpreserved cardiac blood; 16.8 mg/L in preserved vitreous; 61.7 mg/L in unpreserved urine; and 9.8 g/L in stomach contents. Ethanol, analyzed by headspace GC-FID, was present in preserved (fluoride-oxalate) femoral venous blood, urine, and vitreous at concentrations of 232 mg/100 mL, 297 mg/100 mL, and 192 mg/100 mL, respectively. Death was attributed to meptazinol and ethanol toxicity, with atherosclerotic coronary artery disease as a contributing factor.
authors.affiliation: Centre for Forensic and Legal Medicine, University of Dundee, Dundee, Scotland, United Kingdom. p.d.maskell@dundee.ac.uk
authors.forename: Peter D
authors.initials: PD
authors.lastname: Maskell
authors.forename: Giorgia
authors.initials: G
authors.lastname: De Paoli
authors.forename: L Nitin
authors.initials: LN
authors.lastname: Seetohul
authors.forename: Derrick J
authors.initials: DJ
authors.lastname: Pounder
mesh_terms: D002851:Chromatography, High Pressure Liquid; D000431:Ethanol / Q000506:poisoning*; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D008621:Meptazinol / Q000493:pharmacokinetics / Q000506:poisoning*; D008875:Middle Aged
chemical_list: D008621:Meptazinol; D000431:Ethanol