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Related Concept Videos

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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The elimination half-life and drug clearance of drugs following nonlinear kinetics can vary with dosage. The Michaelis-Menten parameters and drug concentration influence these factors. As the dose increases, the elimination half-life tends to lengthen, resulting in a reduction in clearance and a disproportionately larger area under the curve. The total clearance can be derived from the Michaelis-Menten equation for drugs following a one-compartment model.
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When it comes to infants and young children, they are typically administered smaller doses of medication in comparison to adults. This is primarily because their organ functions still need to fully develop, meaning their bodies are not as efficient at metabolizing or eliminating drugs. Additionally, their blood-brain barrier is more permeable than in adults. As a result, high concentrations of drugs can easily penetrate the central nervous system (CNS), potentially leading to neurological...
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Circadian rhythms are cyclic changes that are crucial in plasma drug concentrations. Various standard circadian parameters, including core body temperature, heart rate, and other cardiovascular factors, directly impact disease states and the therapeutic response to drug therapy.
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Related Experiment Video

Updated: Jun 9, 2025

A Convenient Method for Extraction and Analysis with High-Pressure Liquid Chromatography of Catecholamine Neurotransmitters and Their Metabolites
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Postmortem diphenhydramine blood concentrations in children.

H Rachelle Wallage1, Marie Elliot1

  • 1The Centre of Forensic Sciences, 25 Morton Shulman Ave, Toronto, ON M3M 0B1, Canada.

Journal of Analytical Toxicology
|October 25, 2024
PubMed
Summary

Postmortem blood analysis revealed diphenhydramine (an antihistamine) in seven children. Two deaths were linked to diphenhydramine toxicity, while five cases showed incidental detection.

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Area of Science:

  • Forensic Toxicology
  • Clinical Chemistry
  • Pediatric Pharmacology

Background:

  • Diphenhydramine, a first-generation antihistamine, is widely used for allergies, insomnia, and cold symptoms.
  • While newer antihistamines offer fewer side effects, first-generation agents remain therapeutically relevant in pediatric populations.
  • Dimenhydrinate, a diphenhydramine precursor, is used for nausea and vomiting.

Purpose of the Study:

  • To determine postmortem blood concentrations of diphenhydramine in pediatric cases.
  • To investigate the potential role of diphenhydramine in pediatric mortality.

Main Methods:

  • Liquid chromatography-tandem mass spectrometry (LC-MS/MS) was employed for quantitative analysis.
  • Postmortem blood samples from seven children were analyzed for diphenhydramine levels.

Main Results:

  • Diphenhydramine concentrations ranged from 0.051 to 2.6 mg/L in the studied pediatric cases.
  • Diphenhydramine toxicity was identified as a contributing factor in the cause of death for two children.
  • In the remaining five cases, diphenhydramine was detected incidentally, not related to the cause of death.

Conclusions:

  • Diphenhydramine can be present at toxic levels in children, potentially leading to fatalities.
  • Forensic analysis is crucial for distinguishing between toxic and incidental diphenhydramine detection in pediatric postmortem investigations.
  • This study highlights the importance of considering diphenhydramine toxicity in pediatric deaths, even when other causes are apparent.