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Drug Concentrations: Measurements01:23

Drug Concentrations: Measurements

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Drug concentration is the quantity of a drug present in a biological sample. Measuring drug amounts in biological samples allows the clinician to understand how a drug is absorbed, distributed, metabolized, and excreted. Samples can be obtained through invasive or non-invasive methods. Invasive techniques involve surgical or parenteral interventions to gather blood, cerebrospinal fluid, or tissue biopsy. Conversely, non-invasive approaches provide samples like urine, feces, and saliva.
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Drug Toxicity: Risk factors01:24

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Adverse Drug Reactions (ADRs) are potential complications that arise during pharmacotherapy, influenced by multiple risk factors. Age plays a significant role; both neonates and the elderly are at heightened risk due to their respective immature and diminished metabolic and elimination processes. Gender also impacts ADRs, with females experiencing a 1.5 to 1.7-fold greater risk than males, which may be linked to pharmacokinetic, pharmacodynamic, and hormonal differences. Notably, neonates, the...
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Drug toxicities can be stratified into pharmacological, pathological, or genotoxic based on their mechanisms. The incidence and severity of these toxicities generally increase with the drug's concentration in the body and exposure time.Pharmacological toxicity is evident when the therapeutic effects of drugs overshoot into adverse reactions in a predictable, dose-dependent manner. Central nervous system (CNS) depression from barbiturates is a classic example, with effects escalating from...
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Toxidromes: Clinical Features01:30

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Toxidromes are specific patterns of symptoms resulting from toxic substance exposure. They help in the identification and treatment of poisoning. The symptoms of each toxidrome group indicate poisoning by a certain class of chemicals or drugs.1. Sympathomimetic: Stimulates the sympathetic nervous system. Symptoms include agitation, increased heart rate (HR), blood pressure (BP), respiratory rate (RR), temperature, and pupil size. Drugs like cocaine and amphetamines, along with tremors and...
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Drug toxicity: Idiosyncratic Reactions01:16

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Idiosyncratic drug reactions represent abnormal chemical responses that vary significantly among individuals, ranging from extreme sensitivity to low doses to insensitivity to high doses. These reactions often occur due to the drug's covalent binding with serum proteins, forming a foreign hapten that triggers an immunotoxicological response. The variability in drug reactions has a strong pharmacogenetic foundation, with genetic differences crucial in how individuals metabolize drugs. For...
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Rapid High-throughput Species Identification of Botanical Material Using Direct Analysis in Real Time High Resolution Mass Spectrometry
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Mitragynine concentrations in two fatalities.

Olwen Domingo1, Gabriele Roider1, Andreas Stöver1

  • 1Institute of Forensic Medicine, Department of Toxicology, University of Munich, 80336 Munich, Germany.

Forensic Science International
|January 17, 2017
PubMed
Summary
This summary is machine-generated.

Fatalities linked to recreational Mitragyna speciosa (kratom) use were examined. Extremely high mitragynine levels were found, but kratom was not the direct cause of death in these cases.

Keywords:
Concentration dependent effectsDiastereomersKratomMitragynine“Legal high”

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Area of Science:

  • Forensic Toxicology
  • Pharmacology

Background:

  • Recreational use of Mitragyna speciosa (kratom) is prevalent.
  • Mitragynine is the primary psychoactive alkaloid in kratom.

Observation:

  • Two fatalities were reported where kratom use was confirmed.
  • One case exhibited exceptionally high postmortem mitragynine blood concentrations.

Findings:

  • Despite high mitragynine levels, kratom was not identified as the direct cause of death in either fatality.
  • Significant differences in mitragynine and its diastereomer ratios were observed between the two cases.

Implications:

  • Extremely high mitragynine concentrations alone may not be sufficient to cause acute overdose fatalities.
  • Further research is needed to understand the toxicological profile and role of kratom in complex fatalities.