[Personalized character of toxic effects through mass nonlethal poisoning by phenazepam and other psychoactive substances].

Q4 Medicine Sudebno-Meditsinskaya Ekspertisa Pub Date : 2024-01-01 DOI:10.17116/sudmed20246701147

V D Akimova, S S Barsegyan, T V Pleteneva

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Abstract

Over several months, 14 people were admitted in 6 hospitals with severe symptoms of intoxication with psychoactive substances as a result of mass poisoning. All symptoms occurred after taking a drink that contained crushed phenazepam tablets. Samples of blood (n=10) and urine (n=6) taken from 14 sufferers for forensic, chemical and toxicological examination were analyzed using the HPLC-MS/MS method. Phenazepam was detected in the biomaterial of all 14 patients. Other psychoactive substances (baclofen, pregabalin, chlorprothixene, chlorpromazine, phenibut, tramadol, diazepam), narcotic substances and ethanol were also found in the sufferers. The phenazepam concentration in the blood was in the range of 109.75-786.50 ng/ml, in the urine - 8.97-101.28 ng/ml. The pharmacokinetic and toxicokinetic characteristics of toxicants as well as additional factors characterizing the phenotype of the sufferer in addition to drug's content in the biological material must be taken into account to determine the toxicity level of phenazepam against the background of combined action with other psychoactive substances.

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[通过苯西泮和其他精神活性物质造成的大规模非致命中毒，个性化地确定毒性效应的特征]。

几个月来，6 家医院收治了 14 名因集体中毒而出现精神活性物质中毒严重症状的患者。所有症状都是在服用了含有压碎的苯西泮药片的饮料后出现的。采用 HPLC-MS/MS 方法对 14 名中毒者的血液（10 人份）和尿液（6 人份）样本进行了法医、化学和毒理学检查分析。在所有 14 名患者的生物材料中都检测到了非那西泮。在患者体内还发现了其他精神活性物质（巴氯芬、普瑞巴林、氯普噻辛、氯丙嗪、菲尼布汀、曲马多、地西泮）、麻醉物质和乙醇。血液中的苯西泮浓度为 109.75-786.50 纳克/毫升，尿液中的苯西泮浓度为 8.97-101.28 纳克/毫升。在确定苯西泮与其他精神活性物质联合作用的毒性水平时，必须考虑到毒物的药代动力学和毒代动力学特征，以及除了生物物质中的药物含量外，患者表型特征的其他因素。

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

Sudebno-Meditsinskaya Ekspertisa Medicine-Pathology and Forensic Medicine

CiteScore

0.60

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0.00%

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期刊介绍： The journal is concerned with the theory and practice of forensic medicine - the problems of thanatology, traumatology, toxicology, serology, forensic obstetrics, forensic dentistry, forensic psychiatry, forensic chemistry, physicotechnical methods of investigation, history of forensic medicine and some problems of criminology and legal laws related to forensic medicine. It publishes original studies by Russian authors, casuistry surveys, abstracts and reviews of Russian and foreign literature, scientific information, reports on scientific conferences.