Postmortem findings of pipamperone after fatal intoxications and its distribution in body fluids and tissues

Dirty Sprite, also known as “lean” or “purple drank”, is a preparation associated with the presence of codeine and promethazine. These drinks, predominantly used by young people, are mixtures of, for example, soft drinks, prescription medicines, and prescription cough syrups. The use of these illicit preparations started in Texas in the 1960s and become popularized in the 1990s. However, the misuse of these cocktails has become more common in other countries to date, for example, in Thailand. Given the illicit nature of these preparations and the lack of information available on the composition of these products, there is a need to identify and quantify the drugs that may be present. Three samples of Dirty Sprite were analyzed using GC–MS after liquid/liquid‐extraction under acidic and basic conditions. Since the acidic extraction did not show the detection of relevant substances, samples were alkalized to pH ≥ 9, followed by extraction with 1‐chlorobutane. GC–MS screening revealed the identification of codeine, dihydrocodeine, promethazine and impurities of cocaine. A selected ion monitoring method was developed for the quantification of these compounds using lemonade as a calibration matrix. Quantitative analysis showed concentrations of 130‐mg/L codeine, 75‐mg/L promethazine, and 3.4‐mg/L cocaine in sample 1; 74‐mg/L promethazine and 91‐mg/L dihydrocodeine in sample 2; and 130‐mg/L codeine combined with 68‐mg/L promethazine in sample 3. The results also illustrate that the consumption of drugs detected in Dirty Sprite samples could lead to health risks given that these prescription medicines are consumed outside the medical environment.

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“…This target‐screening includes more than 200 drugs. Details on this methods were published elsewhere 14,15 …”

Section: Methodsmentioning

confidence: 99%

Detection of pharmaceuticals in “dirty sprite” using gas chromatography and mass spectrometry

Rosenberger

Teske

Klintschar

et al. 2021

Drug Testing and Analysis

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“…A Shimadzu HPLC plus an Applied Biosystems API 5500 QTrap tandem mass spectrometer was used for detection. As the applied LC‐MS/MS method was described in a previous paper, it is only specified in Table S1 10 . In addition, Table 2 lists the MS/MS parameters of the examined cardiovascular drugs and internal standards.…”

Section: Methodsmentioning

confidence: 99%

“…As the applied LC- MS/MS method was described in a previous paper, it is only specified in Table S1. 10 In addition, Table 2 lists the MS/MS parameters of the examined cardiovascular drugs and internal standards. Besides the presented drugs, further ones were simultaneously detected, which will not be described in this paper.…”

Section: Liquid Chromatography-electrospray Mass Spectrometrymentioning

confidence: 99%

Determination of drugs in exhumed liver and brain tissue after over 9 years of burial by liquid chromatography‐tandem mass spectrometry—Part 1: Cardiovascular drugs

Bolte

Dziadosz

Kono

et al. 2020

Drug Testing and Analysis

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This paper presents analytical results of cardiovascular drugs that were determined in exhumed liver and brain tissue in a total of 115 cases. Exhumations were executed after 9.5–16.5 years of burial. Analysis was performed by solid phase extraction and liquid chromatography–electrospray mass spectrometry. Bisoprolol, verapamil, and xipamide could be proven in all cases in which these were supposedly administered within a defined time frame. Amiodarone was detectable in over 90%, amlodipine in over 80%, and cafedrine, clonidine, phenprocoumon, and torsemide in over 50% of relevant cases. By contrast, atropine, esmolol, furosemide, hydrochlorothiazide, and lisinopril were found in less than 50% of relevant cases, but nifedipine and nitrendipine were not detectable at all. The percentage of positive results for liver and brain tissue for the relevant administered drugs and corresponding postmortem periods are presented per analyte. Neither time since death nor stage of degradation was a reliable predictor of the success rate, as exemplarily shown for furosemide. The presented data may serve as a reference when deciding whether to exhume a corpse for forensic‐toxicological examinations in comparable cases.

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“…For analysis, a Shimadzu high performance liquid chromatography (HPLC) combined with an Applied Biosystems API 5500 QTrap tandem mass spectrometer was used. Table S1 summarizes the applied liquid chromatography–tandem mass spectrometry (LC–MS/MS) method which was defined in a previous paper 1,9 . The MS/MS parameters of the presented pharmaceuticals and internal standards are listed in Table 3.…”

Section: Methodsmentioning

confidence: 99%

“…Table S1 summarizes the applied liquid chromatography-tandem mass spectrometry (LC-MS/MS) method which was defined in a previous paper. 1,9 The MS/MS parameters of the presented pharmaceuticals and internal standards are listed in Table 3. Further drugs were simultaneously measured but their parameters will not be defined here.…”

Section: Liquid Chromatography-electrospray-mass Spectrometrymentioning

confidence: 99%

Determination of drugs in exhumed liver and brain tissue after over 9 years of burial by liquid chromatography–tandem mass spectrometry—Part 2: Benzodiazepines, opioids, and further drugs

Bolte

Dziadosz

Kono

et al. 2021

Drug Testing and Analysis

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In this publication, benzodiazepines, opioids, and further drugs were analyzed in exhumed brain and liver tissue samples in 116 cases (total) after 9.5-16.5 years of burial. Solid phase extraction followed by liquid chromatography-tandem mass spectrometry was applied. Data from literature is listed summarizing the detectability of the presented analytes after a certain time of burial. In our study, 60% of the analyzed benzodiazepines, 100% of the opioids, and 82% of further drugs were detectable. Only the benzodiazepines lorazepam, nitrazepam, flunitrazepam, and its metabolite norflunitrazepam, and the drugs butylscopolamine, metronidazole, and omeprazole were not detectable at all. Percentage of positive findings (total, and separately for brain and liver tissue) and postmortem period are listed for each analyte. Correlation of detectability depending on postmortem period and condition of tissue are presented exemplarily for midazolam. No substantial correlation was observed. Despite a long time of burial, most benzodiazepines, opioids, and further drugs were detectable in the examined tissue samples. Our results may be a good support for future exhumations in which toxicological analyses are relevant.

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Postmortem findings of pipamperone after fatal intoxications and its distribution in body fluids and tissues

Cited by 8 publications

References 20 publications

Detection of pharmaceuticals in “dirty sprite” using gas chromatography and mass spectrometry

Detection of pharmaceuticals in “dirty sprite” using gas chromatography and mass spectrometry

Determination of drugs in exhumed liver and brain tissue after over 9 years of burial by liquid chromatography‐tandem mass spectrometry—Part 1: Cardiovascular drugs

Determination of drugs in exhumed liver and brain tissue after over 9 years of burial by liquid chromatography–tandem mass spectrometry—Part 2: Benzodiazepines, opioids, and further drugs

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