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Four nonfatal and six fatal cases of opiate use: utility of morphine, its metabolites, and their ratios in blood specimens

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Abstract

Four nonfatal and six fatal cases of opiate use are presented with careful toxicological analysis. Levels of morphine (M), 6-monoacetylmorphine (6-MAM), morphine-6-glucuronide (M6G), and morphine-3-glucuronide (M3G) in blood specimens were measured by the sophisticated method of liquid chromatography (LC)-electrospray ionization (ESI)-tandem mass spectrometry (MS-MS). Fatal cases were characterized by much higher levels of free M than the nonfatal cases; this caused lower ratios of M6G/M and M3G/M in the fatal cases when compared with the nonfatal cases. Among the six fatal cases, the M6G/M ratios were especially low in four cases, in which rapid deaths were estimated. The present data are compared with data previously reported by other groups, and we discuss the utility of the levels of M, M6G, and M3G in blood and their ratios for estimating the antemortem status of each individual.

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Authors and Affiliations

  1. Department of Toxicology, Institute of Forensic Medicine, Collegium Medicum, Jagiellonian University, 16 Grzegórzecka St., 31-531, Kraków, Poland

    Małgorzata Kłys & Sebastian Rojek

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  1. Małgorzata Kłys
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  2. Sebastian Rojek
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Correspondence to Małgorzata Kłys.

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Kłys, M., Rojek, S. Four nonfatal and six fatal cases of opiate use: utility of morphine, its metabolites, and their ratios in blood specimens. Forensic Toxicol 26, 87–90 (2008). https://doi.org/10.1007/s11419-008-0056-8

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  • DOI: https://doi.org/10.1007/s11419-008-0056-8

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