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High-throughput and Comprehensive Drug Surveillance Using Multisegment Injection-Capillary Electrophoresis-Mass Spectrometry
Published on: April 23, 2019
Postmortem drug levels: innocent bystander or guilty as charged.
1Department of Pharmacy, Department of Pulmonary and Critical Care, Department of Pharmacology, RUSH University Medical Center, Chicago, IL 60612, USA. gourang_p_patel@rush.edu
Journal of Pharmacy Practice
|January 5, 2012
Summary
Forensic drug levels require careful interpretation alongside clinical context. Postmortem drug concentrations may not reflect pre-death levels, preventing misdiagnosis of poisoning.
Area of Science:
- Forensic Toxicology
- Clinical Pharmacology
Background:
- Determining the cause of death in forensic cases involves evaluating multiple theories.
- Serum drug concentrations are a critical piece of information in cases involving medication.
Purpose of the Study:
- To emphasize the importance of correlating drug levels with the clinical scenario in forensic investigations.
- To caution against relying solely on drug levels for determining cause of death.
Main Methods:
- Review of factors influencing drug level interpretation, including time of sample collection, sample source, and reference ranges.
- Analysis of postmortem drug distribution and its impact on serum concentrations.
Main Results:
- Drug levels can be highly variable and influenced by numerous confounders.
- Postmortem redistribution can cause elevated drug levels, mimicking poisoning.
Conclusions:
- Conclusions regarding drug-related deaths should not be based solely on drug levels.
- Comprehensive review of the clinical scenario, literature, and drug properties is essential for accurate forensic interpretation.
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