title: The pathogenetic role of adulterants in 5 cases of drug addicts with a fatal outcome.
abstract: The purpose of the present study is to determine the role of lidocaine, caffeine and dextromethorphan, used as adulterant substances, in five cases of drug overdose which have come to our attention. Taking into account the pharmacological mechanism, blood concentration and route of administration (intravenous) we evaluated the hypothesis that these substances could act with a synergistic effect - or at least additive - with the illicit drugs on the central nervous system and cardiovascular system.
authors.affiliation: Department G.F. Ingrassia, Laboratory of Forensic Toxicology, University of Catania, Italy.
authors.forename: Nunziata
authors.initials: N
authors.lastname: Barbera
authors.forename: Francesco Paolo
authors.initials: FP
authors.lastname: Busardò
authors.forename: Francesca
authors.initials: F
authors.lastname: Indorato
authors.forename: Guido
authors.initials: G
authors.lastname: Romano
mesh_terms: D000328:Adult; D000779:Anesthetics, Local / Q000032:analysis; D000996:Antitussive Agents / Q000032:analysis; D001646:Bile / Q000737:chemistry; D001923:Brain Chemistry; D002110:Caffeine / Q000032:analysis; D000697:Central Nervous System Stimulants / Q000032:analysis; D015283:Citalopram / Q000032:analysis; D003061:Codeine / Q000032:analysis; D003915:Dextromethorphan / Q000032:analysis; D004340:Drug Contamination; D062787:Drug Overdose; D055030:Drug Users; D005260:Female; D049429:Forensic Pathology; D053593:Forensic Toxicology; D005766:Gastrointestinal Contents / Q000737:chemistry; D006801:Humans; D013287:Illicit Drugs / Q000737:chemistry*; D007668:Kidney / Q000737:chemistry; D008012:Lidocaine / Q000032:analysis; D008099:Liver / Q000737:chemistry; D008168:Lung / Q000737:chemistry; D008297:Male; D008691:Methadone / Q000032:analysis; D009020:Morphine / Q000032:analysis; D009022:Morphine Derivatives / Q000032:analysis; D009294:Narcotics / Q000032:analysis; D011759:Pyrrolidines / Q000032:analysis; D017367:Selective Serotonin Reuptake Inhibitors / Q000032:analysis; D019966:Substance-Related Disorders / Q000150:complications*; D014822:Vitreous Body / Q000737:chemistry
chemical_list: D000779:Anesthetics, Local; D000996:Antitussive Agents; D002110:Caffeine; D000697:Central Nervous System Stimulants; D015283:Citalopram; D003061:Codeine; D003915:Dextromethorphan; D013287:Illicit Drugs; D008012:Lidocaine; D008691:Methadone; D009020:Morphine; D009022:Morphine Derivatives; D009294:Narcotics; D011759:Pyrrolidines; D017367:Selective Serotonin Reuptake Inhibitors; C026979:6-O-monoacetylmorphine; C010724:2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine