ChemPath: Drug, Forensics and Toxicology Flashcards
What sorts of deaths are reported to the coroner?
- Violent
- Unnatural or sudden
- Cause of death is unknown
A number of these require analysis for drugs and alcohol in order to establish the cause of death
What sorts of case types are reported to the coroner?
- Addicts / drug use
- Sudden unexplained / natural
- Hanging
- Overdoses
- Road Traffic Collisions
- Train deaths
- Self-inflicted injury
- Fire
What samples do coroners take?
- Ante-mortem serum / blood
- Post-mortem blood
- Heart blood, cavity blood (screening)
- Femoral vein blood (screening and quantitation)
- Urine
- Stomach contents
- Vitreous humor
- Hair
- Liver
- Others – bile, muscle, powders, syringes
What is the most common drug problem?
Alcohol
What are the main problems associated with alcohol?
- OD
- Accidents including RTCs
- Additive effects other respiratory depressant drugs
What are the main problems associated with heroine?
- 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
What is toxicology?
Concerned with anaylsing samples of drugs/poisins and interpreting the significance of the results.
What does ‘forensic’ mean?
Results/reports used in court
Why might drug levels appear erroneoously elevated post-mortem?
Tissue breakdwon can lead to the release of drugs from various tissues
Where can a sample be taken from for drug concentration measurement?
Femoral vein blood
When is vitreous humour used as a sample?
Used to measure glucose (may be elevated in DKA)
How can heroin overdose kill?
Respiratory depression or aspiration pneumonitis
What are the acute dangers of cocaine?
- Cardiac dysrhythmias
- Acute heart failure
- MI
What is the effectof mixing ethanol with cocaine?
Forms cocaethylene which prolongs the effects of cocaine
What happes to cocaine in post-mortem blood?
Breaks down rapidly so the concentration in post-mortem blood may be considerable lower than at the time of death.