Forensic Toxicology Laboratory Manager

San Diego, CA, United States

Forensic Toxicology Laboratory Manager

San Diego, CA, United States

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Hamm C.E.,Forensic Toxicology Laboratory Supervisor | Gary R.D.,Forensic Toxicologist | McIntyre I.M.,Forensic Toxicology Laboratory Manager
Forensic Science International | Year: 2016

Gabapentin is a widely prescribed medication used primarily for the treatment of epilepsy and neuropathic pain. Gabapentin has a favorable adverse effect profile in therapeutic dosing with the most common reported effects being dizziness, fatigue, drowsiness, weight gain, and peripheral edema. Even with intentional self-poisonings, serious effects are generally rare. In this report, gabapentin analyses were performed on 30 postmortem cases that had peripheral blood, central blood and liver tissue. Overall the central to peripheral blood (C/P) ratio mean was 0.90 ± 0.24 (mean ± standard deviation), and a median of 0.97. The liver to peripheral blood (L/P) ratio mean was 0.68 ± 0.26 L/kg (mean ± standard deviation), and a median of 0.65 L/kg. An additional case, where both antemortem blood and postmortem peripheral blood specimens were available, revealed the same gabapentin concentration in both specimens. Taken together, the data presented suggests that gabapentin is unlikely to show postmortem redistribution. © 2016 Elsevier Ireland Ltd.


PubMed | Forensic Toxicology Laboratory Manager, Forensic Toxicology Laboratory Supervisor and Forensic Toxicologist
Type: | Journal: Forensic science international | Year: 2016

Gabapentin is a widely prescribed medication used primarily for the treatment of epilepsy and neuropathic pain. Gabapentin has a favorable adverse effect profile in therapeutic dosing with the most common reported effects being dizziness, fatigue, drowsiness, weight gain, and peripheral edema. Even with intentional self-poisonings, serious effects are generally rare. In this report, gabapentin analyses were performed on 30 postmortem cases that had peripheral blood, central blood and liver tissue. Overall the central to peripheral blood (C/P) ratio mean was 0.900.24 (meanstandard deviation), and a median of 0.97. The liver to peripheral blood (L/P) ratio mean was 0.680.26L/kg (meanstandard deviation), and a median of 0.65L/kg. An additional case, where both antemortem blood and postmortem peripheral blood specimens were available, revealed the same gabapentin concentration in both specimens. Taken together, the data presented suggests that gabapentin is unlikely to show postmortem redistribution.


Saitman A.,University of California at San Diego | Fitzgerald R.L.,University of California at San Diego | McIntyre I.M.,Forensic Toxicology Laboratory Manager
Forensic Science International | Year: 2015

Postmortem changes can alter the concentration of drugs in the vascular compartment as compared with concentrations originally present at the time of death. Numerous drugs have been reported to increase due to postmortem redistribution (PMR). The potential for PMR of hydrocodone, a therapeutic opioid analgesic used to manage pain, is of particular interest due to its wide use. Hydrocodone concentrations in 39 peripheral blood, central blood, and liver specimens were compared. Dihydrocodeine (DHC), a commonly encountered hydrocodone metabolite, was present in 61% of the cases with an average concentration that was 29% of the hydrocodone value. Central blood to peripheral blood hydrocodone ratios were well correlated (R2=0.965) with an average (±S.D.) of 1.3 (±0.35) and a median of 1.2. The liver to peripheral blood (L/P) hydrocodone ratio was also well correlated (R2=0.915) with an average (±S.D.) of 3.4 (±1.7)L/kg and a median of 3.0L/kg. This low L/P ratio suggests that hydrocodone is unlikely to undergo substantial PMR changes. © 2014 Elsevier Ireland Ltd.


PubMed | Forensic Toxicology Laboratory Manager
Type: Journal Article | Journal: Forensic science, medicine, and pathology | Year: 2014

The liver to peripheral blood (L/P) ratio, based upon review of previously published works, was evaluated as a marker of postmortem redistribution (PMR). Literature supported the proposed model that drugs exhibiting an L/P ratio of less than 5 are prone to little or no PMR, while those with an L/P ratio greater than 20-30 have propensity for significant redistribution. Many antidepressants, including both tricyclic antidepressants and selective serotonin re-uptake inhibitors, were markedly differentiated from drugs previously verified to be free from, or exhibit little, PMR. The magnitude of the liver to blood concentrations also appeared to provide an advantage over the conventional central to peripheral blood ratio model of PMR by demonstrating a wide range of values (1.6-97) for interpretation of drugs potential for, and variations in, redistribution.

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