Pregabalin is an anticonvulsant and analgesic designed to treat neuropathic pain and partial seizure disorders and has been available in Australia as a prescription medication since 2005. Studies have found high rates of polydrug use associated with pregabalin and it is reportedly used recreationally for its euphoric and relaxing effects as well as to self-manage opioid withdrawal symptoms. A robust analytical method for the analysis of pregabalin using protein precipitation and LC/MS/MS was developed, validated and employed in routine case work. In recent years a substantial increase in pregabalin detections in coronial case submissions had been noted. This study examines the case characteristics and outcomes of 332 coronial cases submitted to the laboratory and analyzed for pregabalin between 2015 and 2017. Pregabalin was identified in approximately 5% of all coronial cases submitted during this time. A high rate of concurrent drug use with pregabalin was evident with the predominant classes being opioids, benzodiazepines and anti-depressants. Post-mortem blood pregabalin concentrations ranged from <0.05 to 140 mg/kg (median 5.5 mg/kg); however, limited interpretation of levels could be achieved as the drug was rarely identified in the absence of other drugs. Cause of death (COD) was found to be drug related in 58% of all cases, with mixed drug toxicity specifically mentioned as related to COD in 40% of cases.

中文翻译：

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普瑞巴林及其在冠状动脉疾病中的作用。

普瑞巴林是一种抗惊厥药和止痛药，用于治疗神经性疼痛和部分性癫痫发作，自2005年以来已在澳大利亚作为处方药上市。研究发现，普瑞巴林与多药合用的比例很高，据报道，由于普瑞巴林的欣快和放松作用，其被娱乐性使用效果以及对阿片类药物戒断症状的自我管理。开发，验证和使用了用于蛋白质沉淀和LC / MS / MS的普瑞巴林分析的可靠分析方法，并用于常规案例研究中。近年来，已注意到在冠状动脉病例中普瑞巴林的检出率显着增加。这项研究检查了2015年至2017年间提交给实验室并分析普瑞巴林的332例冠状动脉病例的病例特征和结局。在此期间提交的所有冠状动脉病例中，约有5％检出了普瑞巴林。普瑞巴林同时使用毒品的比例很高，其中主要的类是阿片类药物，苯二氮卓类和抗抑郁药。验血后普瑞巴林的浓度范围从<0.05至140 mg / kg（中位数5.5 mg / kg）；但是，由于缺乏其他药物时很少发现该药物，因此只能对水平进行有限的解释。在所有病例中，发现死因（COD）与药物有关，占58％，其中有40％的病例特别提到混合药物毒性与COD有关。死后血液中普瑞巴林的浓度范围从<0.05至140 mg / kg（中位数5.5 mg / kg）；但是，由于缺乏其他药物时很少发现该药物，因此只能对水平进行有限的解释。在所有病例中，发现死因（COD）与药物有关，占58％，其中有40％的病例特别提到混合药物毒性与COD有关。验血后普瑞巴林的浓度范围从<0.05至140 mg / kg（中位数5.5 mg / kg）；但是，由于缺乏其他药物时很少发现该药物，因此只能对水平进行有限的解释。在所有病例中，发现死因（COD）与药物有关，占58％，其中有40％的病例特别提到混合药物毒性与COD有关。