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[Postmortem evaluation of barbiturate poisonings].

A Schmoldt, E R Beckmann, W Horstmann

    Zeitschrift Fur Rechtsmedizin. Journal of Legal Medicine
    |January 1, 1984
    PubMed
    Summary

    Postmortem liver examination can reveal chronic barbiturate abuse. Specific liver cell changes indicate tolerance, aiding in determining cause of death when drug levels are low.

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    Journal of analytical toxicology·2004

    Area of Science:

    • Forensic Pathology
    • Toxicology
    • Hepatology

    Context:

    • Determining cause of death can be challenging with sub-therapeutic barbiturate levels.
    • Chronic barbiturate use leads to tolerance, a factor often unknown in postmortem investigations.
    • Morphological changes in the liver may serve as indicators of chronic drug abuse.

    Purpose:

    • To investigate whether chronic abuse of specific barbiturates induces observable morphological changes in the liver.
    • To assess if these liver changes correlate with barbiturate tolerance.
    • To determine the utility of liver histology in postmortem evaluation of barbiturate intoxication.

    Summary:

    • Chronic abuse of seco-, cyclo-, brallo-, and/or pentobarbital causes hypertrophy of the smooth endoplasmic reticulum in hepatocytes, similar to phenobarbital.
    • These specific liver changes were not observed in acute barbiturate overdose or with chronic opiate abuse.
    • Light microscopic examination of liver tissue can identify barbiturate tolerance.

    Impact:

    • Provides a reliable postmortem method for evaluating barbiturate tolerance.
    • Aids forensic pathologists in determining cause of death when drug concentrations are inconclusive.
    • Enhances understanding of the long-term hepatic effects of barbiturate abuse.

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