Personalized character of toxic effects through mass nonlethal poisoning by phenazepam and other psychoactive substances

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Over several months, 14 people were admitted in 6 hospitals with severe symptoms of intoxication with psychoactive substances as a result of mass poisoning. All symptoms occurred after taking a drink that contained crushed phenazepam tablets. Samples of blood (n=10) and urine (n=6) taken from 14 sufferers for forensic, chemical and toxicological examination were analyzed using the HPLC-MS/MS method. Phenazepam was detected in the biomaterial of all 14 patients. Other psychoactive substances (baclofen, pregabalin, chlorprothixene, chlorpromazine, phenibut, tramadol, diazepam), narcotic substances and ethanol were also found in the sufferers. The phenazepam concentration in the blood was in the range of 109.75—786.50 ng/ml, in the urine — 8.97—101.28 ng/ml. The pharmacokinetic and toxicokinetic characteristics of toxicants as well as additional factors characterizing the phenotype of the sufferer in addition to drug’s content in the biological material must be taken into account to determine the toxicity level of phenazepam against the background of combined action with other psychoactive substances.

Keywords:

mass poisoning

phenazepam

psychoactive substances

personalized medicine

forensic chemical analysis

Authors:

Orlova A.M.

Russian Center of Forensic Medical Examination

ORCID: 0000-0003-0689-7704

Barsegyan S.S.

Russian Center of Forensic Medical Expertise;
Peoples’ Friendship University of Russia

ORCID: 0000-0001-6234-4253

Pleteneva T.V.

Serbsky Federal Medical Research Centre of Psychiatry and Narcology

ORCID: 0000-0001-7297-980X

Received:

01.08.2023

Accepted:

15.08.2023

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Receiver 01.08.2023

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