Estimating antemortem drug concentrations from postmortem blood samples: the influence of postmortem redistribution: Table 1

Journal of Clinical Pathology - Tập 53 Số 4 - Trang 282-285 - 2000
D S Cook1, R A Braithwaite1, K A Hale1
1Regional Laboratory for Toxicology, City Hospital NHS Trust, Birmingham B18 7QH, UK

Tóm tắt

Aims—To compare blood drug concentrations during life with postmortem drug concentrations measured from a peripheral site and a central site.

Methods—Coroner's cases from October 1990 to July 1997 were reviewed. Six cases had data on both antemortem and postmortem blood drug concentrations. The postmortem to antemortem ratio was compared with the postmortem central to peripheral ratio, using cardiac blood as a central site and femoral blood as a peripheral site.

Results—Drugs that have a high postmortem central to peripheral ratio; that is, drugs that exhibit considerable postmortem redistribution, also have high postmortem to antemortem ratios.

Conclusions—A large degree of error can arise from attempting to estimate antemortem drug concentrations and the ingested dose from postmortem measurements. The chosen site and technique for postmortem blood sampling can greatly influence the concentration of drug measured.

Từ khóa


Tài liệu tham khảo

Gee DJ, Dalley RA, Green MA, et al. Post mortem diagnosis of barbiturate poisoning. In: Ballantyne B, ed. Forensic toxicology. Proceedings of a symposium held at the chemical defence establishment, Porton Down. Bristol: John Wright and Sons, 1972:37–51.

Anderson WH, Prouty RW. Postmortem redistribution of drugs. In: Baselt RC, ed. Advances in analytical toxicology, Vol. 2. Chicago: Year Book Medical Publications, 1989:70–102.

Hilberg T, Bugge A, Beylich K-M, et al. Postmortem changes of amitriptyline concentration in rats. In: Kaempe B, ed. Proceedings of the 29th international meeting of the Association of Forensic Toxicologists, Copenhagen, 1991:395–402.

10.1007/BF02340830

1993, J Forensic Sci, 38, 81, 10.1520/JFS13378J

10.1016/0379-0738(94)90241-0

10.1093/jat/11.5.186

10.1097/00007691-199212000-00004

Mayer JM, Kofoed J, Robinson DW. Postmortem changes in drug concentrations in the blood. In: Jones GR, Singer PP, eds. Proceedings of the 24th international meeting of the Association of Forensic Toxicologists, Banff, Canada, 18–31 July 1987. Edmonton, Canada: Alberta Society of Clinical and Forensic Toxicologists:40–7.

Pounder DJ. The nightmare of postmortem drug changes. In: Wecht CH, ed. Legal medicine 1993. Salem, New Hampshire: Butterworth Legal Publishers, 1994:163–91.

Prouty RW, Anderson WH. Postmortem redistribution of drugs. In: Jones GR, Singer PP, eds. Proceedings of the 24th international meeting of the Association of Forensic Toxicologists, Banff, Canada, 18–31 July 1987. Edmonton, Canada: Alberta Society of Clinical and Forensic Toxicologists: 1–21.

10.1016/0379-0738(94)90273-9

1994, Am J Forensic Med Pathol, 15, 231, 10.1097/00000433-199409000-00010

10.1016/0379-0738(90)90182-X

10.1093/jat/18.6.354

Yonemitsu K, Pounder DJ. Temporal changes in postmortem drug levels in co-proxamol poisoning. In: Kaempe B, ed. Proceedings of the 29th international meeting of the Association of Forensic Toxicologists, Copenhagen, 1991:300–8.

1978, J Forensic Sci, 23, 329, 10.1520/JFS10764J

Jones GR. Postmortem changes in drug levels: a common phenomenon? In: Heyndrickx B, ed. Proceedings of the 23rd international meeting of the Association of Forensic Toxicologists, Ghent, Belgium. International Association of Forensic Toxicologists, 1986:29–35.

10.1177/096032719501400709

Baselt RC, Cravey RH. Disposition of toxic drugs and chemicals in man, 4th ed. California: Chemical Toxicology Institute, 1995.

1995, Journal of Canadian Society of Forensic Science, 28, 113, 10.1080/00085030.1995.10757474

1995, J Forensic Sci, 40, 980, 10.1520/JFS13867J

10.1016/0379-0738(92)90180-5

Péclet C, Picotte P, Rousseau JJ, et al. Post-mortem release phenomenon: a study of blood levels in 121 cases of drug related deaths. In: Jones GR, Singer PP, eds. Proceedings of the 24th international meeting of the Association of Forensic Toxicologists, Banff, Canada, 18–31 July 1987. Edmonton, Canada: Alberta Society of Clinical and Forensic Toxicologists: 22–31.

1978, Am J Psychiatry, 135, 1325, 10.1176/ajp.135.11.1325

10.1093/jat/4.5.232

10.1093/jat/13.4.197

10.1007/BF01369670