Interpretation of drug concentrations in an alternative matrix: the case of meprobamate in bile

Int J Legal Med. 2009 Mar;123(2):97-102. doi: 10.1007/s00414-008-0259-x. Epub 2008 Jun 26.

Abstract

Investigating toxicological causes of death may require alternative matrices when the usual ones are lacking. Whereas forensic toxicology uses bile almost only for xenobiotic screening, a diagnostic test interpreting postmortem bile concentrations of meprobamate is reported. Based on 128 sets of autopsy data, its intrinsic qualities were good, with 0.95 sensitivity and 0.93 specificity. In a French forensic population, the positive and negative predictive factors were 0.90 and 0.97, respectively. It is a useful means of revealing overdoses where blood samples are not available or of confirming blood tests when postmortem redistribution is suspected.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Bile / chemistry*
  • Drug Overdose
  • Female
  • Forensic Toxicology / methods
  • Gas Chromatography-Mass Spectrometry
  • Humans
  • Hypnotics and Sedatives / analysis*
  • Linear Models
  • Male
  • Meprobamate / analysis*
  • Middle Aged
  • Predictive Value of Tests
  • Reproducibility of Results
  • Retrospective Studies
  • Sensitivity and Specificity
  • Young Adult

Substances

  • Hypnotics and Sedatives
  • Meprobamate