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Post-mortem clinical pharmacology.

R E Ferner1

  • 1West Midlands Centre for Adverse Drug Reactions, City Hospital and Department of Clinical Pharmacology, The Medical School, University of Birmingham, Birmingham, UK. r.e.ferner@bham.ac.uk

British Journal of Clinical Pharmacology
|July 22, 2008
PubMed
Summary
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Post-mortem drug concentrations are unreliable for clinical pharmacology due to sample degradation and redistribution. Interpreting these post-mortem measurements requires extreme caution, as they can be misleading.

Area of Science:

  • Forensic Pharmacology
  • Clinical Toxicology

Background:

  • Clinical pharmacology relies on drug concentrations and pharmacokinetic parameters.
  • Post-mortem changes significantly invalidate these assumptions.

Purpose of the Study:

  • To evaluate the reliability of post-mortem drug concentration measurements.
  • To highlight the challenges in interpreting these values for clinical pharmacology.

Main Methods:

  • Review of post-mortem changes affecting drug concentrations.
  • Analysis of post-mortem redistribution phenomena.
  • Assessment of qualitative and quantitative analytical limitations.

Main Results:

  • Post-mortem changes make drug concentration interpretation difficult or impossible.

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  • Qualitative tests may yield false positives or negatives.
  • Quantitative analysis is prone to errors due to unpredictable concentration variations.

    • Conclusions:

    • Post-mortem drug concentrations are unreliable for clinical pharmacology.
    • Compilations of 'lethal concentrations' are misleading.
    • Caution is advised when interpreting post-mortem measurements without further studies.