AI Article Synopsis
- - A man in his forties was found dead at a friend's house, with toxicological analysis revealing fatal levels of caffeine and other drugs commonly found in an over-the-counter cough medicine called BRON, which is sold in Japan.
- - The analysis showed significant concentrations of caffeine, chlorpheniramine, dihydrocodeine, and methylephedrine, with caffeine being classified as a methylxanthine and primarily metabolized by cytochrome P450 (CYP)1A2, which can be inhibited by fluvoxamine.
- - The study concluded that his death resulted from an overdose of BRON, highlighting the need to consider drug interactions, as fluvoxamine's inhibition of caffeine metabolism likely increased his caffeine
Article 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 BRON, 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 BRON overdose. Inhibition of caffeine metabolism may increase blood caffeine concentrations. This suggests that more attention should be paid to potential interactions between multiple drugs.
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| http://dx.doi.org/10.1016/j.legalmed.2023.102294 | DOI Listing |
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Article Synopsis
- - A man in his forties was found dead at a friend's house, with toxicological analysis revealing fatal levels of caffeine and other drugs commonly found in an over-the-counter cough medicine called BRON, which is sold in Japan.
- - The analysis showed significant concentrations of caffeine, chlorpheniramine, dihydrocodeine, and methylephedrine, with caffeine being classified as a methylxanthine and primarily metabolized by cytochrome P450 (CYP)1A2, which can be inhibited by fluvoxamine.
- - The study concluded that his death resulted from an overdose of BRON, highlighting the need to consider drug interactions, as fluvoxamine's inhibition of caffeine metabolism likely increased his caffeine
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