An Experimental Methodology for the Study of Postmortem Changes in Toxic Concentrations of Drugs, Using Secobarbital As an Example

Quatrehomme, Gérald; Bourret, F.; Liu, Zuliang; Ollier, A.

doi:10.1520/jfs13716j

Cited by 18 publications

(5 citation statements)

References 21 publications

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“…Autopsies were performed anywhere from immediately after death to 7 days after death. With increasing time between death and autopsy, secobarbital concentrations increased (55). As previously discussed, the variation in time from death to blood sampling may account for the differences between studies in concentrations of morphine and its glucuronide metabolites as well as the detection of cocaine and its metabolites.…”

Section: Time Of Samplingmentioning

confidence: 88%

Key Concepts in Postmortem Drug Redistribution

Yarema¹,

Becker²

2005

LCLT

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Postmortem redistribution (PMR) refers to the changes that occur in drug concentrations after death. It involves the redistribution of drugs into blood from solid organs such as the lungs, liver, and myocardium. Drug properties such as volume of distribution, lipophilicity, and pKa are important factors. Basic, highly lipophilic drugs with a volume of distribution greater than 3 l/kg are most likely to undergo PMR. Examples include the tricyclic antidepressants, digoxin, and the amphetamines. The anatomical location of blood sampling can influence the drug concentration. The ideal site is a ligated or clamped femoral vein. Medical toxicologists participating in forensic cases involving drugs likely to undergo PMR must be aware of its potential contribution to the postmortem drug concentration. Correlation with laboratory data and any available antemortem or perimortem clinical information is necessary to render an appropriate opinion on the cause of death.

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Section: Time Of Samplingmentioning

confidence: 88%

Key Concepts in Postmortem Drug Redistribution

Yarema¹,

Becker²

2005

LCLT

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“…From the available data, it seems that redistribution mainly occurs in the early postmortem period, as significant increases in concentrations by passive diffusion from reservoir organs have been demonstrated during the first postmortem hours for many substances . However, cellular autolysis and bacterial metabolism may also result in later changes, in both central and peripheral sites . Conversely, some studies have determined that there is little evidence of time‐dependent variability at either central or peripheral site .…”

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confidence: 99%

Site‐, Technique‐, and Time‐Related Aspects of the Postmortem Redistribution of Diazepam, Methadone, Morphine, and their Metabolites: Interest of Popliteal Vein Blood Sampling

Lemaire

Schmidt

Dubois³

et al. 2017

Journal of Forensic Sciences

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Sampling site, technique, and time influence postmortem drug concentrations. In 57 cases, we studied drug concentration differences as follows: subclavian vein‐dissection/clamping versus blind stick, femoral vein‐dissection/clamping versus blind stick, right cardiac chamber, and popliteal vein‐dissection and clamping only. Cases were distributed in group #1 (all cases with both techniques), group #2 (dissection/clamping), and group #3 (blind stick). Sampled drugs were diazepam, methadone, morphine, and their metabolites. To assess PMR, mean concentrations and ratios were calculated for each group. Time‐dependent variations of blood concentrations and ratios were also assessed. Results indicate that site, method, and time may influence postmortem distribution interpretation in different ways. Popliteal blood seems less subject to PMR. In conclusion, our study is the first to evaluate concurrently three main aspects of PMR and confirms that the popliteal vein may represent a site that is more resistant to the changes seen as a result of PMR.

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“…Many drugs are sequestered within tissues during life and are released into the blood in the postmortem interval (10)(11)(12)(13). This can cause dramatic elevations of drug concentration in postmortem blood taken from some visceral sites, such as the heart and aorta, whereas the drug concentration in blood from other sites, such as the femoral vein, change to a lesser degree.…”

Section: Discussionmentioning

confidence: 99%

“…Postmortem degradation of drugs and poisons is a process that is little understood, but that may significantly affect our interpretation of postmortem toxicological results, which are very much dependent on the process that takes place after death (8). As it follows from investigations of many authors, redistribution is a complex phenomenon and the magnitude and range of this process are mainly dependent on the type of xenobiotic, its partition coefficient, its ability to bind with proteins, and also on the time lapse between the poisoning and death and on the postmortem period (the time between death and autopsy) (9)(10)(11)(12)(13). The resuscitation procedures carried out before death, which force a specific pattern of blood circulation in the organism, cannot be underestimated (14).…”

Section: Introductionmentioning

confidence: 99%

Case Study: Distribution and Redistribution of Levomepromazine and its Metabolites in a Fatal Poisoning

Kłys¹,

Bujak-Giżycka²,

Klementowicz³

et al. 2003

Canadian Society of Forensic Science Journal

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The subject of the study is a fatal poisoning with levomepromazine. A toxicological investigation carried out by means of the liquid chromatographic method with mass detection (LC/MS) revealed levomepromazine and its 24 metabolites in postmortem specimens in various concentrations depending on the specimen tested. The study was undertaken not only for judicial evidence, but also to investigate whether any changes occur in the concentrations of xenobiotics found in blood during the postmortem interval. The investigation confirmed such differences in xenobiotic concentrations, proving tha~the passive diffusion of xenobiotics in a body takes place. RESUMECette etude presente un cas d'intoxication fatale SI la levomepromazine;les analyses toxicologiques effectuees par chromatographie Iiquide-spectrometrie de masse (CUSM) ont permis de demontrer la presence de levomepromazine et 24 de ses metabolites dans plusieurs prelevements biologiques postmortem SI diverses concentrations. Cette etude a ete faite autant pour recueillir certains elements de preuve que pour etudier les changements dans les concentrations sanguines de certains xenobiotiques durant la perlode postmortem. Le resultat de cette etude nous a permis de confirmer ces differences dans les concentrations sanguines postmortem prouvant ainsi leur diffusion passive dans I'organisme.

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An Experimental Methodology for the Study of Postmortem Changes in Toxic Concentrations of Drugs, Using Secobarbital As an Example

Cited by 18 publications

References 21 publications

Key Concepts in Postmortem Drug Redistribution

Key Concepts in Postmortem Drug Redistribution

Site‐, Technique‐, and Time‐Related Aspects of the Postmortem Redistribution of Diazepam, Methadone, Morphine, and their Metabolites: Interest of Popliteal Vein Blood Sampling

Case Study: Distribution and Redistribution of Levomepromazine and its Metabolites in a Fatal Poisoning

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