Volume 28, Issue 2 (April 1983)

    The General Toxicology Unknown II. A Case Report: Doxylamine and Pyrilamine Intoxication

    (Received 1 March 1982; accepted 9 August 1982)

    Published Online: April

    CODEN: JFSOAD

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    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.


    Author Information:

    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, Chicago, 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, Chicago, 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, Chicago, 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, Chicago, 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, Chicago, 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, Chicago, IL


    Stock #: JFS11521J

    ISSN: 0022-1198

    DOI: 10.1520/JFS11521J

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    Author
    Title The General Toxicology Unknown II. A Case Report: Doxylamine and Pyrilamine Intoxication
    Symposium , 0000-00-00
    Committee E30