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YEAR 5: Chemical Pathology > ChemPath: Drug, Forensics and Toxicology > Flashcards

ChemPath: Drug, Forensics and Toxicology Flashcards

1
Q

What sorts of deaths are reported to the coroner?

A
  1. Violent
  2. Unnatural or sudden
  3. Cause of death is unknown

A number of these require analysis for drugs and alcohol in order to establish the cause of death

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2
Q

What sorts of case types are reported to the coroner?

A
  • Addicts / drug use
  • Sudden unexplained / natural
  • Hanging
  • Overdoses
  • Road Traffic Collisions
  • Train deaths
  • Self-inflicted injury
  • Fire
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3
Q

What samples do coroners take?

A
  • Ante-mortem serum / blood
  • Post-mortem blood
    • Femoral vein blood (screening and quantitation) preferred
    • Heart blood, cavity blood (screening)
  • Urine (UDS)
  • Stomach contents
  • Vitreous humor
  • Hair (timeframe for drugs)
  • Liver (when nothing else available)
  • Others – bile, muscle, powders, syringes
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4
Q

Techniques used for analysis and screening in toxicology

A

Gas and Liquid chromatography

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5
Q

What is the most common drug problem?

A

Alcohol

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6
Q

What are the main problems associated with alcohol?

A
  • OD
  • Accidents including RTCs
  • Additive effects other respiratory depressant drugs
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7
Q

What are the main problems associated with heroine?

A
  • IV injection, volatilised
  • Fatal OD with both routes of ingestion
  • Additive effects other respiratory depressant drugs
  • Few rapid deaths
  • Most respiratory depression or aspiration pneumonitis
  • Tolerance
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8
Q

What is toxicology?

A

Concerned with anaylsing samples of drugs/poisins and interpreting the significance of the results.

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9
Q

What does ‘forensic’ mean?

A

Results/reports used in court

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10
Q

Why might drug levels appear erroneoously elevated post-mortem?

A

Tissue breakdwon can lead to the release of drugs from various tissues

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11
Q

Where can a sample be taken from for drug concentration measurement?

A

Femoral vein blood

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12
Q

When is vitreous humour used as a sample?

A

Used to measure glucose (may be elevated in DKA)

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13
Q

How can heroin overdose kill?

A

Respiratory depression or aspiration pneumonitis

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14
Q

What are the acute dangers of cocaine?

A
  • Cardiac dysrhythmias
  • Acute heart failure
  • MI
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15
Q

What is the effectof mixing ethanol with cocaine?

A

Forms cocaethylene which prolongs the effects of cocaine

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16
Q

What happes to cocaine in post-mortem blood?

A

Breaks down rapidly so the concentration in post-mortem blood may be considerable lower than at the time of death.

17
Q

Describe the consequences of amphetamine overdose.

A

Causes hyperthermia → rhabdomyolysis → renal failure

Also has a direct toxic effect on the heart

18
Q

List some examples of legal highs.

A
  • Stimulats (e.g. bath salts)
  • Synthetic cannabinoids
  • Synthetic opioids (e.g. acetylfentanyl)
  • Hallucinogenic compounds
19
Q

How long can drugs be detected for in the:

  1. Blood and serum
  2. Urine
  3. Hair
A
  1. Blood and serum = 12 hours
  2. Urine = 2-3 days
  3. Hair - months/years
20
Q

Why can you do Drug screens using hair?

A

Drug is fixed to hair at root during growth phase

So can be analysed on hair as it grows out of root at 1cm/month

Length of hair is effectively a timeline

21
Q

How are hair samples used in forensic toxicology?

A
  • Demonstrating a history of drug use or lack of it
  • Demonstrating tolerance or lack of tolerance to drugs (helps interpret post-mortem drug concentrations)
  • Compliance with medications (e.g. antipsychotics)

NOTE: hair samples are rarely used in coroner’s toxicology but it is used in forensic investigations

22
Q

What are the issues with hair analysis?

A
  • Environmental contamination
  • Absorbed from sweat or sebum coating the hair
  • Passive inhalation
  • Cosmetic treatment (e.g. shampoo)
  • Hair colour
23
Q

What are the two causes of death due to cocaine use?

A
  • Depression/suicide due to long term cocaine use
  • Sudden unexplained death
24
Q

What are the main drugs used in chemsex?

A

GHB

Methylamphetamine (crystal meth)

Mephedrone

YEAR 5: Chemical Pathology (27 decks)

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