Forensic toxicological implications of pleural effusion; an autopsy case of drug overdose.

UNLABELLED: A fatal poisoning case involving multiple psychotropic drugs is presented. Quantitative toxicological analysis showed that the concentrations of phenobarbital, promethazine, chlorpromazine, alprazolam and bromazepam in the femoral blood were 69.51µg/ml, 32.73µg/ml 24.76µg/ml, 0.04µg/ml and 0.31µg/ml respectively, and large amounts of drugs were also detected in the stomach contents. We concluded that the cause of death was mainly due to overdose of phenobarbital, promethazine and chlorpromazine by massive ingestion, and we also discuss the value of pleural effusions as an alternative specimen for toxicological examination. KEYWORDS: multiple drug - poisoning - liquid chromatography mass spectrometry - phenobarbital - pleural effusion.