Journal of analytical toxicology
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Etomidate is a commonly used anesthetic agent often utilized to induce anesthesia as it has a short half-life and allows for central nervous system depression without causing major cardiovascular disturbances, making it one of the preferred medications for trauma and hemodynamically unstable patients. Thus, etomidate is commonly found during a postmortem drug screen conducted for medicolegal reasons. ⋯ We report of a case of suicide by etomidate with concentrations of 0.40 mg/L in the femoral blood, 0.46 mg/L in the bile, and 0.30 mg/L in the vitreous with a blood alcohol content of 0.119 g/dL. For comparison, we identified two cases in which etomidate was administered during resuscitation after trauma with levels of 0.05 mg/L and < 0.026 mg/L, respectively.
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Delta9-Tetrahydrocannabinol (THC) is the main psychoactive compound present in marijuana. THC can also be found, as a contaminant, in some commercially available hemp products marketed in health food stores and on the internet as a good source of essential fatty acids. The products range from oil to alcoholic beverages to nutritional bars to candies, with oil being the most popular and commonly available. ⋯ No THC was detected in 58% of the products from group 1 and 86% of the products from group 2. The amounts indicate that THC levels in currently marketed hemp products are significantly lower than in those products available before 2003 and reported in previous studies. The results reported here may be used as a general guideline for the THC content of hemp products recently found in the marketplace today.
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The identification of benzodiazepines (BZD) in biological fluids can be a challenging process. The large number of various BZD in pharmaceutical distribution, with similar core structures, and individual metabolic profiles all contribute to a complicated and time-consuming analysis. The purpose of the current study was to evaluate the performance of four commercially available immunoassay urine screening kits for use in a forensic urine analysis testing program. ⋯ In addition, greater than 10,000 randomly collected urine samples were screened at a 200 ng/mL cutoff for each assay. Positive samples were confirmed by gas chromatography-mass spectrometry using a panel of 13 BZD confirmation standards. The Microgenics CEDIA high sensitivity assay demonstrated the highest positive screening rate as well as the highest confirmation rate of the four assays.
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A sensitive and reproducible method for the identification and the quantitative determination of bupropion (BUP) and its major metabolites, hydroxybupropion (OH-BUP) and threohydrobupropion (T-BUP), was developed in blood and urine. The three compounds were extracted with a solid-phase extraction procedure followed by LC-ESI-MS-MS separation and quantification using decadeuterated lidocaine as internal standard. BUP and its metabolites were satisfactorily identified by multiple reactions monitoring detection. ⋯ As samplings were performed at least 72 h after the drug intake, BUP had disappeared from blood, but OH-BUP and T-BUP were present at the concentrations of 5.8 and 30.4 mg/L, respectively. In urine, concentrations ranged from 42.9 mg/L for BUP to 617 mg/L for T-BUP. These results agree with the hypothesis of a successful suicide attempt.
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The concentration ratio of morphine (Mor) over codeine (Cod) in opiate positive blood samples is used to discriminate between the use of illegal heroin (high ratios) and therapeutic codeine (low ratios). However, genetically caused CYP2D6 ultra-rapid metabolism might lead to Mor/Cod comparable to heroin intake. A single oral dose of 30 mg codeine was administered to 11 CYP2D6 ultrarapid metabolizers (UMs) and 12 extensive metabolizers (EMs). ⋯ After 12 h, 9% of the 11 UM and none of the 12 EM had ratios > 1. In urine, Mor/Cod ratios were below one for all EMs and UMs during the first 12 h. Thus, CYP2D6 genotyping in general will not explain Mor/Cod ratios > 1 in plasma or urine, unless the time of drug intake is more than 24 h previous.