Markedly Elevated Carbamazepine-10,11-epoxide/Carbamazepine Ratio in a Fatal Carbamazepine Ingestion

Table 2

Antemortem serum drawn on hospital day #3, morning (processed postmortem).

Analytical methodology	Analyte	Serum result
GC/MS-EI full scan	Caffeine	Positive
HPLC-UV/VIS	Carbamazepine	12 mcg/mL
HPLC-UV/VIS	Carbamazepine-10,11-epoxide	54 mcg/mL
GC/MS-EI full scan	Iminostilbene	Positive
HPLC-UV/VIS	Lamotrigine	5.7 mcg/mL
GC/MS-EI full scan	Fluoxetine	0.3 mcg/mL
GC/MS-EI full scan	Norfluoxetine	Not detected
GC/MS-EI full scan (TMS derivative)	Hydroxyzine	Trace (less than 0.1 mcg/mL)
GC/MS-EI full scan	Hydroxyzine metabolite	Positive
GC/MS-EI full scan	Cetirizine	Positive
GC/MS-EI full scan	Laudanosine (atracurium metabolite, administered in hospital)	Not detected
LC/MS/MS-ESI	Topiramate	28 mcg/mL
GC/MS-EI full scan	Phenytoin (administered in hospital)	Positive