A multiple drug intoxication involving cyclobenzaprine and ibuprofen.

Author(s): Levine B, Jones R, Smith ML, Gudewicz TM, Peterson B

Affiliation(s): Division of Forensic Toxicology, Armed Forces Institute of Pathology, Washington, D.C. 20306-6000.

Publication date & source: 1993-09, Am J Forensic Med Pathol., 14(3):246-8.

Publication type: Case Reports

A 19-year-old black man presented to the emergency room with superficial cuts on the anterior wrists, lethargy, tachycardia, and metabolic acidosis. Multiple containers of medication were found at the scene. Dysrhythmias developed and the patient died 7 h after admission. No anatomic cause of death was identifiable at autopsy. Toxicologic analysis identified the following drugs in the blood (mg/L): cyclobenzaprine (0.3), phenylpropanolamine (2.5), chlorpheniramine (0.2), lidocaine (6.6), phenytoin (19), and ibuprofen (130). Lidocaine and phenytoin had been administered therapeutically. The major symptoms displayed by the patient were tachycardia and metabolic acidosis, symptoms consistent with cyclobenzaprine and ibuprofen intoxication, respectively. Therefore, the medical examiner ruled that the cause of death was multiple drug intoxication and that the manner of death was suicide.