SOFT 2004 Meeting Abstracts - Society of Forensic Toxicologists

P9
DETERMINATION OF OXCARBAZEPINE AND ITS METABOLITES IN POSTMORTEM
SPECIMENS INCLUDING HAIR BY MEANS OF LIQUID CHROMATOGRAPHY WITH MASS
DETECTION (HPLC/APCIIMS) IN AN EPILEPTIC PATIENT AFTER A FATAL DRUG­
POISONING
Malgorzata Klys* and Sebastian Rojek
Grzegorzecka str 16, Krakow, Malopolskie, 31-531, Poland
One use ofhair analysis in forensic toxicology is the documentation of prior drug administration. This is
illustrated in a suicidal death of a 58-year-old epileptic patient who was treated with oxcarbazepine and
probably with levomepromazine.
The toxicological analysis carried out by HPLC/APCIIMS included also the hair (6cm length) besides of
postmortem blood and liver samples. The method was validated for oxcarbazepine (OXCBZ) and its two
metabolites, 10-hydroxycarbazepine (CBZ-100H) and trans-diol-carbazepine (CBZ-diOH) in various
biological matrices.
Thetoxicological findings are as follows:
Hair
Autopsy
Segment (2 Segment (2
Segment (cm)
cm)
cm)
I
II
III
Blood Liver
Concentration (I!Wg)
Oxcarbazepine 3.9 10.4 13.0 0.79 n.d.
18.4
53.9
105.9 13.96 15,28
i CBZ-100H
4.7*
5.1 *
8.1 * 17.6* -
.0.5
1.2
3.0 0.23 n.d
CBZ-diOH
0.12*
0.12* 0.23* 0.29*
-
Levomepromazine - - - 1.96 30,25
*Relatlve concentration metabolite / prekursor
n.d. - not detected
The analysis of the postmortem blood indicated oxcarbazepine and its two main metabolites were present at
therapeutic concentrations; levomepromazine was detected at a fatal concentration. In three 2-cm segments
ofhair,.oxcarbazepine and its two metabolites were detected; however, levomepromazine was not detected
in this . specimen. A complex chemical-toxicological investigation confirmed the information that the
decedent. was an epileptic patient and was treated with oxcarbazepine for at least 6 months before death. In
addition, he took a toxic dose of levomepromazine in order to commit suicide. The analysis revealed
differences between the' concentration levels of oxcarbazepine and its active metabolite CBZ-IOORin
postmortem specimens and hair, suggesting different mechanisms of penetration of certain metabolites and
their precursors into these materials.
Keywords: oxcarbazepine, hair, LClAPCIIMS
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