Sažetak
Uvod. Enzimi citohroma P450 (CYP) su odgovorni za metabolizam različitih lekova i hemikalija. Forenzički patolog treba da razmotri ne samo farmakodinamske interakcije između više lekova već i farmakokinetičke interakcije svakog leka u slučaju multiple ingestije lekova. Prikaz bolesnika. Žena u 40-im godinama, na lečenju od zavisnosti od alkohola, nađena je mrtva u svojoj kući. Medikolegalnom autopsijom nisu nađeni znaci koji bi upućivali na prirodni uzrok smrti. Kvantitativnom toksikološkom analizom nađeno je da su koncentracije levomepromazina, prometazina, dekstrometorfana, estazolama, klomipramina, risperidona i flunitrazepama u femoralnoj krvi bile: 0.750 µg/mL, 0.701 µg/mL, 0.332 µg/mL, 0.390 µg/mL, 0.216 µg/mL, 0.031 µg/mL, i 0.002 µg/mL, redom, uz etil alkohol u krvi u koncentraciji od 377 mg/dL. Zaključak. Zaključili smo da je uzrok smrti bila interakcija između etil alkohola i više psihotropnih lekova. Farmakokinetičke interakcije lekova zbog inhibicije CYP trebalo bi uzeti u obzir kod procene toksičnosti u slučajevima trovanja koji uključuju ingestiju više lekova.
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Reference
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