title: Nefopam Hydrochloride: A Fatal Overdose.
abstract: Nefopam is a non-opiate analgesic commonly used for the treatment of moderate to severe pain. A case of a 37-year-old male who was found dead in the morning is presented. An autopsy was performed and femoral venous blood, heart blood, urine, and vitreous humor were submitted for toxicological analysis. A general drug screen detected the presence of nefopam, caffeine, nicotine, citalopram, gabapentin, amitriptyline, diazepam and paracetamol in cardiac blood. Nefopam was quantitated by high-performance liquid chromatography with diode-array detection. Nefopam was found at the following concentrations: 13.6 mg/L in unpreserved femoral blood; 14.7 mg/L in preserved (fluoride-oxalate) femoral blood; 21.2 mg/L in unpreserved cardiac blood and 4.5 mg/L in preserved vitreous. Citalopram was present at a concentration of 0.7 mg/L (femoral blood) and 0.9 mg/L (cardiac blood). Ethanol analyzed by headspace gas chromatography (GC-FID) was detected in preserved (fluoride-oxalate) vitreous (14 mg/100 mL) and preserved (fluoride-oxalate) urine 50 mg/100 mL. Death was attributed to atherosclerotic coronary artery disease and therapeutic drug toxicity.
authors: Centre for Forensic and Legal Medicine, University of Dundee, Dundee DD1 4HN, UK Present address: School of Science and Technology, Nottingham Trent University, Nottingham, UK nitin.seetohul@ntu.ac.uk.
authors: L Nitin
authors: LN
authors: Seetohul
authors: Centre for Forensic and Legal Medicine, University of Dundee, Dundee DD1 4HN, UK.
authors: Giorgia
authors: G
authors: De Paoli
authors: Centre for Forensic and Legal Medicine, University of Dundee, Dundee DD1 4HN, UK.
authors: Gail
authors: G
authors: Drummond
authors: Centre for Forensic and Legal Medicine, University of Dundee, Dundee DD1 4HN, UK Present address: Department of Chemical and Forensic Sciences, University of Huddersfield, Huddersfield, UK.
authors: Peter D
authors: PD
authors: Maskell
mesh_terms: D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000097:blood* / Q000652:urine*; D001344:Autopsy; D002340:Carotid Artery Diseases / Q000188:drug therapy / Q000401:mortality*; D002423:Cause of Death; D002849:Chromatography, Gas; D002851:Chromatography, High Pressure Liquid; D062787:Drug Overdose / Q000097:blood / Q000401:mortality* / Q000652:urine; D006801:Humans; D008297:Male; D009340:Nefopam / Q000097:blood* / Q000652:urine*; D013405:Suicide
chemical_list: D018712:Analgesics, Non-Narcotic; D009340:Nefopam