Pilot-Reported Beta-Blockers Identified by Forensic Toxicology Analysis of Postmortem Specimens
| Autor: | Kurt M. Dubowski, James M Whinnery, Dennis V. Canfield, Estrella M Forster |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
030110 physiology 0301 basic medicine medicine.medical_specialty Databases Factual Health Toxicology and Mutagenesis Adrenergic beta-Antagonists Toxicology 030226 pharmacology & pharmacy Medical Records Analytical Chemistry Forensic Toxicology Young Adult 03 medical and health sciences Route of administration 0302 clinical medicine Cause of Death Generic drug Sql server Humans Environmental Chemistry Medicine Aged Cause of death Aged 80 and over Chemical Health and Safety business.industry Medical record Forensic toxicology Middle Aged people.cause_of_death Time of death Accidents Aviation Aviation accident Emergency medicine Autopsy business people |
| Zdroj: | Journal of Analytical Toxicology. 42:1-5 |
| ISSN: | 1945-2403 0146-4760 |
| DOI: | 10.1093/jat/bkx076 |
| Popis: | Introduction: This study compared beta-blockers reported by pilots with the medications found by postmortem toxicology analysis of specimens received from fatal aviation accidents between 1999 and 2015. Several studies have compared drugs using the standard approach: Compare the drug found by toxicology analysis with the drug reported by the pilot. This study uniquely examined first the pilot-reported medication and then compared it to that detected by toxicology analysis. This study will serve two purposes: (1) determine the capability of a toxicology laboratory to detect reported medications, and (2) identify pilots with medications below detectable limits. Method: All information required for this study was extracted from the Toxicology Data Base system and was searched using ToxFlo or SQL Server Management Studio. The following information was collected and analyzed: pilot-reported trade and/or generic drug, date specimens received, time of accident, type of aviation operations (CFR), state, pilot level, age, class of medical, specimen type, specimen concentration, dose reported, frequency reported associated with the accident, quantity reported, National Transportation Safety Board (NTSB) accident event number, and all NTSB reports. Results: There were 319 pilots that either reported taking a beta-blocker or were found to be taking a beta-blocker by postmortem toxicology analysis. Metoprolol and Atenolol were the most commonly found beta-blockers (81%) in this study. Discussion: Time of death, therapeutic concentration, and specimen type were found to be factors in the ability of the laboratory to detect beta-blockers. Dose did not correlate with the ability of the toxicology laboratory to detect the beta-blocker. Conclusions: Beta-blockers taken by pilots will, in most cases, be found by a competent postmortem forensic toxicology laboratory at therapeutic concentrations. The dose taken by the pilot was not found to be a factor in the ability of the laboratory to identify beta-blockers. Time of dose, route of administration, specimen tested, and therapeutic concentration of the drug were found to be factors in the ability of the laboratory to identify beta-blockers in postmortem specimens taken from pilots that died in aviation accidents. |
| Databáze: | OpenAIRE |
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