1
|
Niu W, Ren T, Wang Y, Wang Z, Zhang C, Jia J, Wei Z, Su H, Guo Z, Guo X, Yun K. Forensic toxicokinetics of difenidol hydrochloride in vivo verified by practical lethal cases. Sci Rep 2023; 13:11190. [PMID: 37433899 DOI: 10.1038/s41598-023-38246-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 07/05/2023] [Indexed: 07/13/2023] Open
Abstract
A gas chromatography-mass spectrometry (GC-MS) method for the determination of difenidol hydrochloride in biological specimens has been developed. The method exhibited excellent recovery (> 90%) and precision (RSD < 10%), and the LOD was 0.05 μg/mL or μg/g, which met the requirements of bioanalytical method. Through the animal model of the forensic toxicokinetics, the dynamic distribution, postmortem redistribution (PMR) and stability in specimen preservation process of difenidol in animals were studied. The experimental results showed that after intragastric administration, the difenidol's concentrations in the heart-blood and various organs increased over time except stomach, and then decreased gradually after reaching the peaks of concentration. The toxicological kinetics equation and toxicokinetic parameters were established by processing the data of the mean drug concentration of difenidol changing with time. In PMR experiment, the concentrations of difenidol in some organs closer to the gastrointestinal tract (heart-blood, heart, liver, lung, kidney, and spleen) changed significantly at different time points. But the concentration of difenidol in brain tissues which were far away from the gastrointestinal tract and muscles with larger overall mass was relatively stable. PMR of difenidol was therefore confirmed. Thus, the effect of PMR on the concentration of difenidol in the specimens should be considered in cases involving difenidol poisoning or death. Furthermore, the stability of difenidol in heart-blood samples from poisoned rats was investigated at various time points and under different preservation conditions (20 °C, 4 °C, - 20 °C and 20 °C (1% NaF)) for a period of two months. Difenidol was stable and did not decompose in the preserved blood. Therefore, this study provided the experimental basis for the forensic identification of the cases of difenidol hydrochloride poisoning (death). PMR has been verified by practical lethal cases.
Collapse
Affiliation(s)
- Weifen Niu
- School of Forensic Medicine, Shanxi Medical University, Jinzhong, 030600, Shanxi, People's Republic of China
- Shanxi Key Laboratory of Forensic Medicine, Jinzhong, 030600, Shanxi, People's Republic of China
- Key Laboratory of Forensic Toxicology of Ministry of Public Security, Jinzhong, 030600, Shanxi, People's Republic of China
| | - Tongxi Ren
- Institute of Forensic Science of Tianjin Public Security Bureau, Tianjin, 300384, People's Republic of China
| | - Yandan Wang
- School of Forensic Medicine, Shanxi Medical University, Jinzhong, 030600, Shanxi, People's Republic of China
- Shanxi Key Laboratory of Forensic Medicine, Jinzhong, 030600, Shanxi, People's Republic of China
- Key Laboratory of Forensic Toxicology of Ministry of Public Security, Jinzhong, 030600, Shanxi, People's Republic of China
| | - Zheyu Wang
- School of Forensic Medicine, Shanxi Medical University, Jinzhong, 030600, Shanxi, People's Republic of China
- Shanxi Key Laboratory of Forensic Medicine, Jinzhong, 030600, Shanxi, People's Republic of China
- Key Laboratory of Forensic Toxicology of Ministry of Public Security, Jinzhong, 030600, Shanxi, People's Republic of China
| | - Chao Zhang
- School of Forensic Medicine, Shanxi Medical University, Jinzhong, 030600, Shanxi, People's Republic of China
- Shanxi Key Laboratory of Forensic Medicine, Jinzhong, 030600, Shanxi, People's Republic of China
- Key Laboratory of Forensic Toxicology of Ministry of Public Security, Jinzhong, 030600, Shanxi, People's Republic of China
| | - Juan Jia
- School of Forensic Medicine, Shanxi Medical University, Jinzhong, 030600, Shanxi, People's Republic of China
- Shanxi Key Laboratory of Forensic Medicine, Jinzhong, 030600, Shanxi, People's Republic of China
- Key Laboratory of Forensic Toxicology of Ministry of Public Security, Jinzhong, 030600, Shanxi, People's Republic of China
| | - Zhiwen Wei
- School of Forensic Medicine, Shanxi Medical University, Jinzhong, 030600, Shanxi, People's Republic of China
- Shanxi Key Laboratory of Forensic Medicine, Jinzhong, 030600, Shanxi, People's Republic of China
- Key Laboratory of Forensic Toxicology of Ministry of Public Security, Jinzhong, 030600, Shanxi, People's Republic of China
| | - Hongliang Su
- School of Forensic Medicine, Shanxi Medical University, Jinzhong, 030600, Shanxi, People's Republic of China
- Shanxi Key Laboratory of Forensic Medicine, Jinzhong, 030600, Shanxi, People's Republic of China
- Key Laboratory of Forensic Toxicology of Ministry of Public Security, Jinzhong, 030600, Shanxi, People's Republic of China
| | - Zhongyuan Guo
- School of Forensic Medicine, Shanxi Medical University, Jinzhong, 030600, Shanxi, People's Republic of China
- Shanxi Key Laboratory of Forensic Medicine, Jinzhong, 030600, Shanxi, People's Republic of China
- Key Laboratory of Forensic Toxicology of Ministry of Public Security, Jinzhong, 030600, Shanxi, People's Republic of China
| | - Xiangjie Guo
- School of Forensic Medicine, Shanxi Medical University, Jinzhong, 030600, Shanxi, People's Republic of China
- Shanxi Key Laboratory of Forensic Medicine, Jinzhong, 030600, Shanxi, People's Republic of China
- Key Laboratory of Forensic Toxicology of Ministry of Public Security, Jinzhong, 030600, Shanxi, People's Republic of China
| | - Keming Yun
- School of Forensic Medicine, Shanxi Medical University, Jinzhong, 030600, Shanxi, People's Republic of China.
- Shanxi Key Laboratory of Forensic Medicine, Jinzhong, 030600, Shanxi, People's Republic of China.
- Key Laboratory of Forensic Toxicology of Ministry of Public Security, Jinzhong, 030600, Shanxi, People's Republic of China.
| |
Collapse
|
2
|
Takei S, Kinoshita H, Jamal M, Kumihashi M, Yamashita T, Tanaka E, Kawahara S, Abe H, Miyatake N, Kimura S. An autopsy case of BRON TM overdose with multiple drug ingestion. Leg Med (Tokyo) 2023; 64:102294. [PMID: 37369168 DOI: 10.1016/j.legalmed.2023.102294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 06/14/2023] [Accepted: 06/21/2023] [Indexed: 06/29/2023]
Abstract
A man in his forties was found dead in his friend's home, with moderate putrefaction. Quantitative toxicological analysis showed that concentrations of caffeine, chlorpheniramine, dihydrocodeine, and methylephedrine were 183.3 µg/mL, 0.533 µg/mL, 2.469 µg/mL and 8.336 µg/mL, respectively. Ephedrine, amitriptyline, nortriptyline, etizolam, fluvoxamine and 7-aminoflunitrazepam were detected in an aortic blood sample. Caffeine, chlorpheniramine, dihydrocodeine and methylephedrine are the main components of BRONTM, an over-the-counter antitussive sold in Japan. Those concentrations in blood were within fatal ranges. Caffeine is classified as a methylxanthine and is mainly metabolized by cytochrome P450 (CYP)1A2. Fluvoxamine is a potent CYP1A2 inhibitor. Blood fluvoxamine concentration was within the therapeutic range, but would have increased blood caffeine level by the inhibition of caffeine metabolism. The conclusion was that his death was caused by BRONTM overdose. Inhibition of caffeine metabolism may increase blood caffeine concentrations. This suggests that more attention should be paid to potential interactions between multiple drugs.
Collapse
Affiliation(s)
- Sella Takei
- Department of Forensic Medicine, Kagawa University, 1750-1 Miki, Kita, Kagawa 761-0793, Japan.
| | - Hiroshi Kinoshita
- Department of Forensic Medicine, Kagawa University, 1750-1 Miki, Kita, Kagawa 761-0793, Japan
| | - Mostofa Jamal
- Department of Forensic Medicine, Kagawa University, 1750-1 Miki, Kita, Kagawa 761-0793, Japan
| | - Mitsuru Kumihashi
- Department of Forensic Medicine, Kagawa University, 1750-1 Miki, Kita, Kagawa 761-0793, Japan
| | - Tadayoshi Yamashita
- Department of Forensic Medicine, Kagawa University, 1750-1 Miki, Kita, Kagawa 761-0793, Japan
| | - Etsuko Tanaka
- Department of Forensic Medicine, Kagawa University, 1750-1 Miki, Kita, Kagawa 761-0793, Japan
| | - Sachiko Kawahara
- Department of Forensic Medicine, Kagawa University, 1750-1 Miki, Kita, Kagawa 761-0793, Japan
| | - Hiroko Abe
- Biodesign Inc., 3-25-15 Nishi Ikebukuro, Toshima, Tokyo 171-0021, Japan
| | - Nobuyuki Miyatake
- Department of Hygiene, Kagawa University, 1750-1 Miki, Kita, Kagawa 761-0793, Japan
| | - Shoji Kimura
- Department of Forensic Medicine, Kagawa University, 1750-1 Miki, Kita, Kagawa 761-0793, Japan
| |
Collapse
|