Drug concentrations and interactions – therapeutic or toxic?

Abstract

Undertaking toxicological analysis in clinical and post-mortem investigations can assist to determine the extent of drug contribution to compliance, impairment, toxicity and potentially death. The overlap in blood concentrations following drug consumption can be significant and relying solely on a ‘number’ to determine whether or not a drug is therapeutic or toxic is difficult. Some poisons will be toxic at any measurable concentration, but for the vast majority of compounds which are detected routinely in medico-legal casework, the assessment of drug contribution in a case is dependent on many factors. These factors include but are not limited to dose, frequency, administration, drug interactions, natural disease and in some specific situations drug stability and redistribution (i.e., post-mortem). This presentation will provide an overview of the most important considerations for better interpretation of forensic toxicology results with demonstrated case examples.