By Robert A. Maes, Hans Brandenberger
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Extra info for Analytical toxicology for clinical, forensic, and pharmaceutical chemists
If a relatively large volume of urine may be sampled, this has the advantage of increasing the sensitivity of the procedures, although the presence of metabolites often complicates the problem. Quantitative urine levels cannot be used to determine an influence of drugs on behaviour. The presence of a drug in a specimen of urine just means that it has been ingested or administered. 3 Emergency Toxicology Gastric content This is obtained through vomiting or aspiration. The sample may contain large quantities of the native(s) compound(s), allowing for straight identification.
The above facts show that the clinical laboratory must provide a fast response about the identity and concentration of toxic substances. This is an emergency service which has to operate night and day. Historiocally, forensic chemists were the first to provide this type of service to hospitals. Forensic chemistry, however, differs from clinical chemistry as its results must have legal strength. Confirmation of the results by an independent method is much more important than speed. Today, if a forensic laboratory wants to provide service to a hospital, it should have a special section working on a different basis than the forensic section.
The use of moles rather than grams is particularly useful if the method measures metabolites rather than the native compound, as in the example of acetylsalicylate which yields equimolar amounts of salicylate in vivo and contributes to the anion gap on a molar basis. On the other hand it has been advocated that drugs are dosed in grams and not moles, but indeed the relation between the absorbed amount and the serum concentration is generally established on an empirical manner. 3 Follow-up of the patient Successive determination of a toxic compound serves to provide an idea of the intoxication kinetics.
Analytical toxicology for clinical, forensic, and pharmaceutical chemists by Robert A. Maes, Hans Brandenberger