Scopolamine fatal outcome in an inmate after buscopan® smoking

Sabina Strano Rossi, Antonio Oliva, Matteo Polacco, Simone Grassi, Serena Mestria, Giorgio Bolino

Risultato della ricerca: Contributo in rivistaArticolo in rivistapeer review

Abstract

Scopolamine is an alkaloid which acts as competitive antagonists to acetylcholine at central and peripheral muscarinic receptors. We report the case of a 41-year-old male convict with a 27-year history of cannabis abuse who suddenly died in the bed of his cell after having smoked buscopan® tablets. Since both abuse of substances and recent physical assaults had been reported, we opted for a comprehensive approach (post-mortem computed tomography CT (PMCT), full forensic autopsy, and toxicology testing) to determine which was the cause of the death. Virtopsy found significant cerebral edema and lungs edema that were confirmed at the autopsy and at the histopathological examination. Scopolamine was detected in peripheral blood at the toxic concentration of 14 ng/mL in blood and at 263 ng/mL in urine, and scopolamine butyl bromide at 17 ng/mL in blood and 90 ng/mL in urine. Quetiapine, mirtazapine, lorazepam, diazepam, and metabolites and valproate were also detected (at therapeutic concentrations). Inmates, especially when they have a history of drug abuse, are at risk to use any substance they can find for recreational purposes. In prisons, active surveillance on the management and assumption of prescribed drugs could avoid fatal acute intoxication.
Lingua originaleEnglish
pagine (da-a)N/A-N/A
Numero di pagine6
RivistaInternational Journal of Legal Medicine
Volume2021
DOI
Stato di pubblicazionePubblicato - 2021

Keywords

  • Forensic toxicology
  • PMCT
  • Poisoning
  • Scopolamine
  • Scopolamine N-butylbromide

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