Several fatalities due to fluoxetine combined with other drugs such as ethyl alcohol have been reported. We now report an apparent suicide in which fluoxetine was the only causative agent. Because this drug is widely described as having a wide safety margin, it is important to note concentrations in blood associated with overdose fatalities. The findings by GC/NPD and GC/MS in blood were as follows: fluoxetine 6,000 ng and demethylated metabolite 5,000 ng/mL. Parent compound and metabolite were 13,000 ng/mL each in bile. Details of the analytical method and data from 2,100 National Medical Services cases are also presented.
We present a method for salicylates which is slightly more labor intensive than the usual manual Trinder's test, but is much more sensitive and able to identify individual drugs or metabolites. A 2-mL acidified urine aliquot is briefly extracted with 5 mL ether, and the residue from evaporating the ether under nitrogen is chromatographed on a 250-microns silica gel HPTLC plate using benzene-acetic acid-diethylether-methanol (60:9:30:5) as mobile phase and 5% aqueous ferric chloride as chromogen. The hardiness of the method is evidenced by the Rf values, which vary by no more than 3% over a four-month period. The Rf values are 0.70 for salicylic acid and diflunisal, 0.67 for aspirin and methyl salicylate, 0.60 for gentisic acid, 0.57 for p-aminosalicyclic acid, and 0.40 for salicyluric acid. Detection limits of 1 ppm or less for all the analytes compared favorably to limits of more than 20 ppm for Trinder's test. Separations and spot shapes are sufficiently good to make instrumental quantitation potentially applicable. Sensitivity is sufficient to give clearcut, positive test results 48 h after a single 80-mg dose of ASA by mouth or a 100-mg dose of methyl salicylate by skin injection with a muscle rub, and more than 96 h after a 660-mg oral aspirin dose. Thus, the test is useful for detection and a good degree of differentiation, even in patients using subtherapeutic doses of these salicylates or in those with trace residues from significantly remote full therapeutic or larger doses prior to specimen collections.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.