多種類の市販感冒剤服用による一中毒死例

Abstract

A 22-year-old woman was found dead in her locked room. She was suspected to have ingested large amounts of 5 kinds of commercial cold medicine containing varying combinations and contents of analgesic and antipyretic drugs, central stimulants, antitussives, and antihistamines. Drugs were extracted from blood, urine, liver, kidney, brains, and contents of the stomach, and qualitative and quantitative estimation of these drugs was carried out by GC and GC-MS. The concentration (μg/ml) of acetaminophen, dihydrocodein-phosphate, dl-methylephedrine-hydrochloride, caffein, and noscapine in the heart blood were 880, 6, 23, 70, and 114, respectively. The concentrations of acetaminophen, dihydrocodein-phosphate and dl-methyl-ephedrine are high enough to be lethal. Autopsy revealed marked hyperemia in several organs, especially in the lung and kidney. Histological examination of various organs and tissues showed remarkable hyperemia and bleeding in the lung, vacuolation of hepatic cells and hepatic necrosis around the central vein, and necrosis of kidney tubules. These histological findings correspond well to those observed in acetaminophen intoxication. The overdose of acetaminophen, dihydrocodein-phosphate and dl-methyl-ephedrine are supposed to be the cause of death.