TY  - JOUR
PY  - 1999//
TI  - Tissue distribution of tramadol and metabolites in an overdose fatality
JO  - American journal of forensic medicine and pathology
A1  - Moore, K. A.
A1  - Cina, S. J.
A1  - Jones, R.
A1  - Selby, D. M.
A1  - Levine, B.
A1  - Smith, M. L.
SP  - 98
EP  - 100
VL  - 20
IS  - 1
N2  - Tramadol (Ultram) is a centrally acting, synthetic analgesic agent. Although it has some affinity for the opiate receptors, tramadol is believed to exert its analgesic effect by inhibiting the re-uptake of norepinephrine and serotonin. There are several published cases of tramadol's involvement in drug-related deaths and impairment. Reports of deaths involving tramadol alone with associated tissue concentrations are rare. This report documents a case in which tramadol overdose was identified as the cause of death. The following tramadol concentrations were found in various tissues: blood, 20 mg/L; urine, 110.2 mg/L; liver, 68.9 mg/kg; and kidney, 37.5 mg/kg. Tissue distributions of the two primary metabolites, N-desmethyl and O-desmethyl tramadol, are also reported. In each tissue or fluid except urine, the tramadol concentration was greater than either metabolite, consistent with other reports of drug-impaired drivers and postmortem cases. The O-desmethyl metabolite concentration was greater than the N-desmethyl metabolite concentration in all tissues; this is in contrast to other postmortem reports, in which the majority of cases report concentrations of O-desmethyl as less than those of N-desmethyl. This may be useful as an indicator of time lapse between ingestion and death.<p /> <p>Language: en</p>
LA  - en
SN  - 0195-7910
UR  - http://dx.doi.org/
ID  - ref1
ER  -