The Journal of Forensic Toxicology and Pharmacology (JFTP) promotes rigorous research that makes a significant contribution in advancing knowledge of variations in biochemical functions and detailed information on forensic studies. The JFTP includes all major themes pertaining to forensic toxicology and pharmacology.
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Methadone Related Deaths: Identifying The Vulnerable Patients
Methadone has been used in opioid dependence treatment since the 1960s and is now prescribed also as a chronic pain treatment. Even though its effectiveness has been worldwide assessed, literature reports several cases of death associated with the administration of this drug. Risk factors are still uncertain and the frequent combination with other substances of abuse makes it even more difficult to determine the exact role of methadone in the pathogenesis of fatalities. In this paper the authors present the autopsy findings in a subset of deaths characterized by blood being positive for the methadone only at a therapeutic dose in order to point out those pre-existent pathologic conditions that seem to increase the risk of death in methadone treatment.
Thiocyanate Blood Levels in Chlorobenzylidenemalononitrile (CS) Riot Control Gas Patients; the Egyptian Experience
This study aims to clarify the systemic toxic effects of chlorobenzylidenemalononitrile (CS) and to confirm or reject the possibility of cyanide intoxication on the exposed patients. The study was conducted in PCC Ain Shams University, on exposed rioters during the November 2011 demonstrations to CS gas in Cairo. Control groups included light and moderate to heavy smokers as well as non-smokers. Plasma thiocyanate, the metabolite of cyanide was assayed in all groups. Plasma thiocyanate of victims of CS exposed gas showed no significant differences from light smoker volunteers and was not significantly different when followed up after 2 weeks. Clinical and laboratory workup did not detect any of the evidence pertaining to cyanide poisoning. No fatality was recorded in the studied series. It is concluded that transient exposure of street rioters to CS gas (2.8 minutes average) in open air, hence with limited CS gas concentration would not produce cyanide toxicity.
Levamisole in Gastric Content after Unusual Intake of Heroin and Cocaine
Levamisole is an antibiotic medication used to treat colon cancer and is a synthetic imidazothiazole derivative also employed as an antihelminthic to treat worm infestations in both humans and animals. Even if it is not yet well known why levamisole is added to cocaine, the presence of this adulterant is very dangerous, in fact this compound suppresses the production of white blood cells, resulting in neutropenia, agranulocytosis and idiopathic pulmonary hypertension.
An Unusual Homicide Involving Strangulation after Transdermal Fentanyl and Buprenorphine Intoxication
Fentanyl and buprenorphine are powerful opioids used for the induction of anesthesia as well as for severe pain management.Transdermal fentanyl and buprenorphine patches are widely used for outpatient management of chronic pain. However several cases of deaths connected with their administration have been described in literature. We present an unusual and exceptional homicidal death attributed to a combination system of acute transdermal opioids poisoning and strangulation. The concentration of the drugs and their metabolites in femoral blood and urine were capable of causing fatal intoxication. This manner of complex homicide raises the question of the importance of mechanisms involved.