Fatal acute intoxication after snorting cocaine and fluoxetine

IF 1.3 4区医学 Q3 MEDICINE, LEGAL

Legal Medicine Pub Date : 2025-04-01 DOI:10.1016/j.legalmed.2025.102614

Alberto Chighine, Giulio Ferino, Matteo Nioi, Ernesto d’Aloja, Emanuela Locci

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Abstract

A case report of a fatal acute intoxication following cocaine and fluoxetine snorting is described here. A 44-year-old woman with an history of drug abuse was found dead at home. On-site evaluation conducted by police highlighted evidence of recent cocaine consumption whereas no tablets or drug blisters were spotted. In the hypothesis of a drug-related crime the local Prosecutor ordered a judicial autopsy.

Pathological findings were consistent with an acute cardiac failure while toxicological analysis conducted on blood revealed the presence of fluoxetine and cocaine in reportedly fatal concentrations. A blood alcohol concentration of 1.9 g/L was also detected. Nasal swabs were positive for both fluoxetine and cocaine whereas no sign of tablets was spotted in the stomach, which appeared empty.

Death was hence ascribed to an acute cardiac failure secondary to fluoxetine and cocaine intoxication. To the best of the authors knowledge, this is the first post-mortem report of fluoxetine and its active metabolite norfluoxetine in fatal concentrations following intake by snorting.

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吸食可卡因和氟西汀后致命的急性中毒

一个致命的急性中毒后，可卡因和氟西汀鼻吸报告的情况下。一名有药物滥用史的44岁妇女被发现死在家中。警方进行的现场评估强调了最近吸食可卡因的证据，但没有发现药片或毒品水泡。假定与毒品有关的犯罪，当地检察官下令进行司法解剖。病理检查结果与急性心力衰竭相符，而对血液进行的毒理学分析显示，氟西汀和可卡因的浓度据报达到了致死浓度。血液酒精浓度为1.9 g/L。鼻拭子对氟西汀和可卡因均呈阳性，但胃里没有发现药片的迹象，胃看起来是空的。因此，死亡被归因于氟西汀和可卡因中毒引起的急性心力衰竭。据作者所知，这是首个通过吸入氟西汀及其活性代谢物去甲氟西汀致死浓度的尸检报告。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Legal Medicine Nursing-Issues, Ethics and Legal Aspects

CiteScore

2.80

自引率

6.70%

发文量

119

审稿时长

7.9 weeks

期刊介绍： Legal Medicine provides an international forum for the publication of original articles, reviews and correspondence on subjects that cover practical and theoretical areas of interest relating to the wide range of legal medicine. Subjects covered include forensic pathology, toxicology, odontology, anthropology, criminalistics, immunochemistry, hemogenetics and forensic aspects of biological science with emphasis on DNA analysis and molecular biology. Submissions dealing with medicolegal problems such as malpractice, insurance, child abuse or ethics in medical practice are also acceptable.