Blood cocaine and metabolite pharmacokinetics after cardiac arrest in a body-packer case

Author:

de Prost Nicolas1,Mégarbane Bruno2,Questel Frank3,Bloch Vanessa4,Cantin Bertaux Delphine3,Pourriat Jean Louis3,Rabbat Antoine5

Affiliation:

1. Service de pneumologie et réanimation, Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris and Université Paris Descartes, Paris, France

2. Réanimation Médicale et Toxicologique, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris and Université Paris Diderot, Paris, France, INSERM U705, CNRS, UMR 7157, Hôpital Fernand Widal, Assistance Publique-Hôpitaux de Paris and Université Paris Diderot, Paris, France

3. Urgences médico-Judiciaires, Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris and Université Paris Descartes, Paris, France

4. INSERM U705, CNRS, UMR 7157, Hôpital Fernand Widal, Assistance Publique-Hôpitaux de Paris and Université Paris Diderot, Paris, France

5. Service de pneumologie et réanimation, Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris and Université Paris Descartes, Paris, France,

Abstract

Introduction: Cocaine body packing, the internal concealment of cocaine for transportation between countries, may expose to life-threatening intoxications. No data is currently available on the pharmacokinetics of cocaine and its metabolites when a packet rupture occurs in a body packer. Case report: We report the first pharmacokinetic data associated with a severe cocaine intoxication in a body packer, resulting in cardiac arrest. Massive concentrations of cocaine (observed maximal concentration: 1.66 mg/L, 1 hour after the cardiac arrest) were measured in plasma up to about 15 hours, suggesting a prolonged absorption due to a slow-release in the gastrointestinal tract despite surgical extraction of the packets. Apparent cocaine elimination half-life was 7.6 hours. Conclusion: A prolonged apparent cocaine elimination half-life has been observed. Further pharmacokinetic studies are needed to understand better the pathophysiology of acute cocaine intoxication in body packers.

Publisher

SAGE Publications

Subject

Health, Toxicology and Mutagenesis,Toxicology,General Medicine

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