| Title | Postmortem Concentrations of Tramadol and O-Desmethyltramadol in 11 Aviation Accident Fatalities |
|---|---|
| Record ID | 81784 |
| Personal Name Creator |
Lewis, Russell J.; Ritter, Roxane M.; Johnson, Robert D.; Crump, Ryan W. |
| Corporate Creator | United States. Department of Transportation. Federal Aviation Administration. Office of Aviation. Civil Aerospace Medical Institute; University of Central Oklahoma |
| Corporate Contributor |
United States. Department of Transportation. Federal Aviation Administration. Office of Aviation. Office of Aerospace Medicine |
| Publisher | United States. Department of Transportation. Federal Aviation Administration. Office of Aviation. Civil Aerospace Medical Institute |
| Publication Date | 20101201 |
| Language | English |
| Abstract | Tramadol is a centrally acting analgesic used to treat moderate-to-severe pain. Side effects of this medication include dizziness, confusion, drowsiness, seizures, and respiratory depression. Any of these side effects could negatively affect a pilot’s performance and become a factor in an aviation accident. Due to the severity of aviation accidents, blood samples are often not available, and frequently, only tissue specimens are available for analysis. Therefore, understanding the distribution of a drug throughout all fluids and tissues of the body is important when trying to interpret drug impairment and/or intoxication. Our laboratory has determined the distribution of tramadol and its main active metabolite, O-desmethyltramadol, in various postmortem tissues and fluids obtained from 11 fatal aviation accident cases. Whole blood tramadol concentrations obtained from these 11 cases ranged from 81-2720 ng/mL. When available, 10 specimen types were analyzed for each case, including blood, urine, vitreous humor, liver, lung, kidney, spleen, muscle, heart, and brain. Distribution, expressed as specimen/blood ratio, for tramadol was 69 ± 74 in urine, 2.58 ± 3.26 in vitreous humor, 4.90 ± 3.32 in liver, 3.43 ± 2.31 in lung, 3.05 ± 1.49 in kidney, 5.15 ± 2.66 in spleen, 1.18 ± 0.85 in muscle, 2.33 ± 1.21 in brain, and 1.89 ± 1.01 in heart. Distribution coefficients obtained had coefficient of variations (CV) ranging from 49-126%. With such large CV’s, the distribution coefficients have little use in predicting blood concentrations from the analysis of a tissue specimen. This study indicates that tramadol concentrations undergo significant postmortem changes. |
| Rosap ID | dot:57103 |
| Rosap URL | https://rosap.ntl.bts.gov/view/dot/57103 |
| TRT Terms | Toxicology; Air transportation crashes; Aviation safety; Fatalities; Forensic medicine |
| General Subjects | Forensic toxicology; Tramadol; Distribution; GC/MS |
| Geographical Coverage |
United States |
| TRIS Online Accession No |
1324998 |
| Report Number | DOT/FAA/AM-10/19 |
| Resource type | Tech Report |
| URL | https://ntlrepository.blob.core.windows.net/lib/81000/81700/81784/201019.pdf |
| Format | |
| Database | NTL Digital Repository |