Alda Rismas case

Group 6

Anamnesa victims
Consuming alcohol Frequent use of sleeping pills along with alcohol Using a kind of slimming drugs amphetamines and methamphetamine by injection

List of drugs consumed by victim before his death

Amphetamines Sleeping pills (Dormicum) OMZ (omeprazole) Neurobium Diazepam Propofol

Results of corpses autopsy

In the stomach: liquid meth In gall and kidney: morphine In urine: high levels of amphetamine and methamphetamine In body is found benzodentin and propovol which is the leading cause of death

Pharmacokinetics of DORMICUM (Midazolam)

These drugs work quickly within 30 minutes and last up to 5-7 hours. Midazolam bound to plasma proteins as much as 96%. Reshuffle running fast and perfect (60-80%) to active metabolic 1-hydroxymethyl-midazolam were removed through urine in the form of glucuronide. Plasma t 1/2 is very short 1.5 to 2.5 hours and final metabolic is 60-80 minutes.

dose: Sleep Medication: 7.5 to 15 mg (maleate) Local anesthetic premedication: oral 25mg/45 minutes; intramuskular 5 mg (chloride) Side Effects: if the dose exceeds, it will cause respiratory inhibition which can be fatal.

Pharmacokinetics of omeprazole (OMZ)

Inhibition of acid secretion is independent of plasma levels, but from area under the curve (AUC). Its reabsorption complete, in 2-5 hours and binding with plasma protein (95%), plasma t was more or less 1 hour but it works lasted 24 hours. In the liver, these substances completely reformed into inactive metabolites, which are excreted 80% with urine

Between the blood and the effect there is no correlation. Omeprazole decomposes in acidic so need to be acid resistant coated. Side effects: headache, muscle pain, insomnia Elimination of diazepam and fenitoi is inhibited.

pharmacokinetics of diazepam
Using in oral its reabsorption is good and fast, but slow and imperfect in the form of suppositories. In the liver, a N-diazepam is biotransformed to asetildiazepam its active too. The plasma t is between 42-120 hours, plasma t diazepam is between 20-54 hours.

Pharmacokinetics of propofol
After iv injection, propofol quickly distributed to the brain, heart, liver and kidney and redistribution to muscles, skin, bones and fat. Redistribution is causing levels in the brain decreased rapidly. In the liver, profolol reformed into inactive metabolites and are excreted through the urine. Side effects: shortness of breath, cardiovascular depression, excitation light and thrombophlebitis.

CASE ANALYSIS
Consuming sleeping pills along with alcohol will increase its activity and toxicity. Drinking alcohol with empty stomach can increase stomach acid. To drop it is given omeprazole. These drugs can reduce levels of gastric acid very fast and strong with inhibition protons pomp.

 Using of slimming drugs containing amphetamines and methamphetamine stimulates the central nervous system, increasing heart rate and blood pressure. Giving amphetamines to hypoxias symptom will caused tolerance.

 The effects of overdoses will arise pain and spam, giving Neurobion is okay, but not effective. Using diazepam on high dose (400 mg iv) will aggravate hypoxic conditions and cause breathing stopped immediately.

Thank you