A Fatal Case of Poisoning with Fentanyl Transdermal Patches in Japan
A Fatal Case of Poisoning with Fentanyl Transdermal Patches in Japan
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DOI：
10.1111/1556-4029.14127
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发表时间：
2019-11-01
影响因子：
1.6
通讯作者：
Takagi，Tetsuya
中科院分区：
文献类型：
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作者：
Nara，Akina;Yamada，Chiho;Takagi，Tetsuya
芬太尼透皮贴剂已用于治疗癌症和非癌症相关的慢性疼痛。然而，其不当或非法使用可能会导致致命的中毒。我们在此介绍一名 40 多岁的日本女性的案例，她被发现死亡，身上有 7 个 25 微克/小时的芬太尼透皮贴剂。我们建立了详细的毒理学分析程序，通过超高效液相色谱-串联质谱法对人全血中的芬太尼及其代谢物去甲芬太尼和其他药物（对乙酰氨基酚、烯丙基异丙基乙酰脲、塞来昔布、艾司唑仑、异丙嗪和舍曲林）进行定量。股血和心脏血中测得的芬太尼和去甲芬太尼浓度分别为 0.051 和 0.072 μg/mL 以及 0.033 和 0.076 μg/mL。死者的芬太尼浓度与之前报道的芬太尼透皮贴剂中毒致死病例的死后血液浓度一致。根据死者的病史、尸检结果和毒理学分析，死因被确定为透皮芬太尼中毒。
Fentanyl transdermal patches have been used to treat cancer‐ and noncancer‐related chronic pain. However, its inappropriate or illegal application may cause fatal poisoning. We herein present the case of a Japanese woman in her 40s who was found dead with seven 25‐μg/h fentanyl transdermal patches on her body. We established a detailed toxicological analysis procedure to quantify fentanyl, and its metabolite norfentanyl, and other drugs (acetaminophen, allylisopropylacetylurea, celecoxib, estazolam, promethazine, and sertraline) in human whole blood by ultra‐high‐performance liquid chromatography–tandem mass spectrometry. The measured fentanyl and norfentanyl concentrations in the femoral and cardiac blood were 0.051 and 0.072 μg/mL and 0.033 and 0.076 μg/mL, respectively. The decedent's fentanyl concentrations were consistent with previously reported postmortem blood levels for fatal cases of poisoning by fentanyl transdermal patches. Based on the decedent's case history, autopsy findings, and toxicological analyses, the cause of death was identified as intoxication with transdermal fentanyl.