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Anna Nicole Smith Autopsy: Abused Growth Hormone, Killed by Sleeping Aid.

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The coroner's autopsy report (Full autopsy report -- PDF (contains graphic content)), shows that nine prescription drugs (not including metabolites of those drugs) were found in Anna Nicole's body.

A statement by the medical examiner also indicates that Anna Nicole Smith appears to have abused Human Growth Hormone, together with Vitamin B12. HGH is often abused by bodybuilders to increase muscle mass, and is also illegally prescribed together with B12 and other vitamins and hormones, in an attempt to stop aging.

Drug that killed Smith:
Chloral Hydrate (Noctec). This drug is used as a sleeping agent, and most of the time only prescribed if the person can not take benzodiazepines.

Other drugs contributing to death:
1. Diphenhydramine (Bendaryl), used to control allergic reactions.
2. Clonazepam (Klonopin), a benzodiazepine used to treat anxiety and panic attacks.
3. Diazepam (Valium), a benzodiazepine used to treat anxiety and alcohol withdrawal.
a. Nordiazepam (metabolite). Diazepam is metabolized to nordiazepam which is an active metabolite.
b. Temazepam (metabolite). This is a minor active metabolite of diazepam.
c. Oxazepam (metabolite?). This agent was not described as metabolite in report, but it should be noted that diazepam breaks down into oxazepam.
4. Lorazepam, a benzodiazepine used to treat anxiety.

Additional drugs not contributing to death:
8. Atropine, used to temporarily increase heart rate or as an antidote for inadvertent overdose of cholinergic drugs. Likely to have been used during resucitation attempt.
7. Topiramate (Topamaz), used to stop migraines.
8. Ciprofloxacin (Cipro), used to treat a variety of bacterial infections.
9. Acetaminophen (Tylenol), used to control mild to moderate pain and to reduce fever.

(Watch police chief's conclusions on investigation )

During the course of the autopsy, filed under Smith's given name of Vickie Lynn Marshall, doctors found evidence that Smith had an abscess in her left buttock that had been perforated by a needle, probably when she took injections of either the growth hormone or vitamin B-12, the medical examiner explained. The perforation allowed bacteria to get into Smith's blood, which caused a high fever in the days before her death.
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Peter Rost M.D. Peter Rost, M.D., is a former Vice President of Pfizer. He is the author of "The Whistleblower, Confessions of a Healthcare Hitman" and "Killer Drug." He also writes the daily Pharma Law Blog and the Pharma Expert Witness (more...)
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