ISSN: 0022-1198
CODEN: JFSCA
Published Online: 1 April 1983
Page Count: 6

The General Toxicology Unknown II. A Case Report: Doxylamine and Pyrilamine Intoxication
Donoghue, ER
Toxicologist and GC/MS section chief, chief toxicologist, assistant chief toxicologist, toxicologist, deputy chief medical examiner, and chief medical examiner, Cook County Institute of Forensic Medicine, Office of the Medical Examiner, IL

Schaffer, MI
Toxicologist and GC/MS section chief, chief toxicologist, assistant chief toxicologist, toxicologist, deputy chief medical examiner, and chief medical examiner, Cook County Institute of Forensic Medicine, Office of the Medical Examiner, IL

Kurland, ML
Toxicologist and GC/MS section chief, chief toxicologist, assistant chief toxicologist, toxicologist, deputy chief medical examiner, and chief medical examiner, Cook County Institute of Forensic Medicine, Office of the Medical Examiner, IL

Wu Chen, NB
Toxicologist and GC/MS section chief, chief toxicologist, assistant chief toxicologist, toxicologist, deputy chief medical examiner, and chief medical examiner, Cook County Institute of Forensic Medicine, Office of the Medical Examiner, IL

Lin, R-L
Toxicologist and GC/MS section chief, chief toxicologist, assistant chief toxicologist, toxicologist, deputy chief medical examiner, and chief medical examiner, Cook County Institute of Forensic Medicine, Office of the Medical Examiner, IL

Stein, RJ
Toxicologist and GC/MS section chief, chief toxicologist, assistant chief toxicologist, toxicologist, deputy chief medical examiner, and chief medical examiner, Cook County Institute of Forensic Medicine, Office of the Medical Examiner, IL

(Received 1 March 1982; accepted 9 August 1982)

Abstract

A general toxicology unknown case is presented to demonstrate our systematic approach. A 20-year-old male was found dead with multiple suicide notes. Overdose was suspected but substances were not known. Blood alcohol was negative. Urine was analyzed by enzymemultiplied immunoassay technique and was negative for all drugs assayed. Urine was then extracted with ethyl acetate:hexane (1:1) at pH 10 and back-extracted into 1.0N sulfuric acid. The acidic layer was adjusted to pH 10, and re-extracted with ethyl acetate: hexane (1:1). The residue was analyzed by gas chromatography (GC) on a 3% OV-101 column. It was found to be negative for all commonly screened substances. However, several unknown peaks were observed. Electron impact mass spectra of these unknown peaks were obtained and searched for in our computer library of more than 25 000 mass spectra. These unknown peaks were identified as doxylamine and pyrilamine by gas chromatography/mass spectrometry. The base peak and molecular ion for pyrilamine were at m/z 121 and 285, respectively. The base peak for doxylamine was at m/z 58. No molecular ion was observed for doxylamine. Both doxylamine and pyrilamine are antihistamines, but are promoted and used in the management of insomnia. Quantitation was performed on a GC using dexbrompheniramine as an internal standard. Blood concentrations for doxylamine and pyrilamine were 0.7 and 7.0 mg/L, respectively. Concentrations in other tissues were determined. Death was caused by combined doxylamine and pyrilamine intoxication; the manner of death was suicide.

Keywords:
toxicology, doxylamine, pyrilamine, systematic approach, general toxicology unknown, chromatographic analysis, mass spectrometric analysis

Paper ID: JFS11521J
DOI: 10.1520/JFS11521J
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