title: Fatal self administration of tramadol and propofol: a case report.
abstract: We describe a case of unintentional intoxication due to tramadol and propofol self administration, occurred in a middle aged man, healthcare provider, deceased despite advanced medical assistance an hour later the onset of severe and increasing dyspnea. Toxicological analysis performed with gas chromatography-mass spectrometry in blood sample, evidenced a lethal tramadol concentration and therapeutic level of Propofol. Quantitative determination was also performed in other specimens such as bile, tissues (liver, spleen, kidney) and pubic hair, to assess chronic exposure. Toxicological results and autopsy findings, supported by clinical and hematochemical data, suggested a myocardial damage, associated with respiratory failure.
authors.affiliation: Department of Anatomical, Histological, Forensic Medicine and Orthopedic Sciences, Sapienza University of Rome, Viale Regina Elena, 336-00161 Rome, Italy. giuliomann@tin.it
authors.forename: Giulio
authors.initials: G
authors.lastname: Mannocchi
authors.forename: Francesca
authors.initials: F
authors.lastname: Napoleoni
authors.forename: Simona
authors.initials: S
authors.lastname: Napoletano
authors.forename: Flaminia
authors.initials: F
authors.lastname: Pantano
authors.forename: Mariangela
authors.initials: M
authors.lastname: Santoni
authors.forename: Roberta
authors.initials: R
authors.lastname: Tittarelli
authors.forename: Paolo
authors.initials: P
authors.lastname: Arbarello
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000032:analysis / Q000506:poisoning*; D062787:Drug Overdose; D053593:Forensic Toxicology; D008401:Gas Chromatography-Mass Spectrometry; D006197:Hair / Q000737:chemistry; D006282:Health Personnel; D006323:Heart Arrest / Q000139:chemically induced; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage* / Q000032:analysis; D057230:Limit of Detection; D008099:Liver / Q000737:chemistry; D008297:Male; D008875:Middle Aged; D015742:Propofol / Q000008:administration & dosage* / Q000032:analysis; D012131:Respiratory Insufficiency / Q000139:chemically induced; D012646:Self Administration; D019966:Substance-Related Disorders / Q000175:diagnosis*; D014147:Tramadol / Q000008:administration & dosage / Q000032:analysis / Q000506:poisoning*
chemical_list: D000701:Analgesics, Opioid; D006993:Hypnotics and Sedatives; D014147:Tramadol; D015742:Propofol
keywords: Cardiac arrest; GC–MS; Propofol; Toxicological; Tramadol