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Biomedical subjects

J C Garriott

Publications and source records attributed to J C Garriott.

At least 19 recordsLinked to original sources
PubMed1994

Measurements of fentanyl and sufentanil in blood and urine after surgical application. Implication in detection of abuse.

An increase in cases of death from overdose and abuse from fentanyl or sufentanil is being encountered by the Bexar County Forensic Science Center in San Antonio, Texas. These drugs have been abused almost solely by health care professionals. The fentanyl derivatives cannot currently be detected by routine laboratory drug-screening programs. Forensic toxicology assays that identify the specific analyte must be used. We report a sensitive assay for detection of fentanyl and sufentanil with a detection limit of -0.5 ng/ml. In addition, results from the analysis of urine and blood samples obtained up to 72 h after drug administration to five patients undergoing cardiac bypass surgery who had received either fentanyl or sufentanil are described. The new procedure enables detection of these drugs more readily, in smaller amounts, and for a longer period of time after use than previously possible. We hope this will lead to intervention and treatment in those abusing the drugs.

Aged↗
PubMed1993

A case of fatal ingestion of malathion.

We report a case of suicide due to organophosphate poisoning in an 80-year-old woman who ingested malathion mixed with a fruit drink. She presented with signs and symptoms of cholinergic crisis and initially improved with therapy. Her plasma cholinesterase (ChE) level remained low, her course progressively deteriorated with respiratory and renal failure, and she died 12 days after hospital admission. The antemortem blood malathion level of 23.9 mg/L is the highest reported in the literature, as determined by modern methods. Postmortem toxicologic analysis revealed still greatly reduced ChE activity.

Aged↗
PubMed1993

Drug use among homicide victims. Changing patterns.

Complete toxicology screens were performed on Bexar County homicide victims in four recent representative years (1985, 1986, 1990, and 1991). A high positivity rate for drugs and/or alcohol, ranging from 66 to 73%, was found for each year. Alcohol was present in more than half of the cases, ranging from 54.2 to 60.3%. Detection of cocaine or cocaine metabolites increased drastically during this study period, from 1.6% of cases in 1985 to 18.7% in 1991. Heroin metabolites, indicative of recent heroin use, were detected in only 2-5% of the cases in each of the years studied. Drugs other than alcohol, cocaine, or heroin were detected in 7-25% of the cases.

Adolescent↗
PubMed1992

Alcohol and motorcycle riders: a comparison of motorcycle and car/truck DWIs.

Alcohol's effects on balance and motor coordination would be expected to have greater consequences for motorcycle riders than car/truck drivers. Driving while intoxicated/under the influence (DWI) reports for 1984 and 1985 from the San Antonio, TX, Police Department were reviewed to evaluate motorcycle DWIs, and to compare them with car/truck DWIs. During the 2-y period there were 100 DWI reports involving motorcycle riders, which were compared to 100 involving car/truck drivers. Motorcycle riders were all male and younger (mean 26 y) than car/truck drivers (p less than 0.05). Initiation of the DWI investigation of motorcycle riders was more frequently due to excessive speed, and less likely due to an accident, when compared to car/truck investigations. Breath alcohol testing demonstrated a significantly lower blood alcohol concentration in motorcycle riders, 0.14 +/- 0.05 g/dL, than in car/truck drivers, 0.16 +/- 0.05 g/dL (p = 0.016). The results of this study suggest that alcohol influences motorcycle riders to a greater extent than it does car/truck drivers. Further data is needed to determine whether lower blood alcohol concentration limits should be considered for the definition of "driving while impaired" in motorcycle riders.

Alcoholic Intoxication↗
PubMed1991

Eye injuries with metal missiles presenting to an emergency center: a three year study.

The authors retrospectively evaluated 33 eye injuries due to metal missiles in 31 patients presenting to our emergency center over the last 3 years. Injuries occurred most frequently when the patients were grinding metal or working on their cars. The type of metal involved in the injury often dictates the type of ophthalmic reaction that will occur. A discussion of intraocular metallic foreign bodies with an emphasis on electroretinograms and metal analysis is presented.

Adolescent↗
PubMed1991

Skeletal muscle as an alternative specimen for alcohol and drug analysis.

In a random group of medical examiner cases, muscle tissue, as well as blood and vitreous humor, was analyzed for ethyl alcohol, and the results were compared. When the blood concentration was greater than 0.10 g/dL, the muscle to blood ratio was 1.00 or less (average 0.94), and when the blood concentration was less than 0.10 g/dL, this ratio was greater than 1.00 (average 1.48). The author proposes that this ratio is dependent upon the time course of absorption and distribution, as has been observed for vitreous humor, but with a more rapid equilibration. Muscle tissue was also analyzed in another group of cases found to be positive for one or more drugs in blood. The concentrations of the drugs in muscle varied from none detected to 6.5 times those in blood and seemed to be dependent on the time course between ingestion and death, as well as on the nature of the drug. For most common basic drugs, the ratios were often near unity. Muscle is proposed as a useful alternative specimen to postmortem blood.

Antidepressive Agents, Tricyclic↗
PubMed1987

A fatal poisoning from Nicotiana glauca.

A young adult male was found dead in a field. No cause of death was apparent at autopsy, and the only positive toxicological finding was the presence of a nicotine-like alkaloid isolated from the liver. Anabasine, the major, highly toxic alkaloid of the shrub, Nicotiana glauca (tree tobacco) was subsequently identified in all body specimens examined using gas chromatography/mass spectrometry. Concentrations of anabasine in blood, urine and other body organs are reported.

Adult↗
PubMed1986

Blood pentobarbital concentrations during thiopental therapy.

The desulfuration of thiopental to pentobarbital has previously been shown to be a relatively minor pathway of thiopental metabolism. In two cases, we observed significant conversion, resulting in blood pentobarbital concentrations up to 50 percent of total blood barbiturate (thiopental and pentobarbital) concentrations. Both patients received continuous infusions of thiopental and had present a condition (hypothermia) or drug (cimetidine) known to inhibit hepatic microsomal enzyme activity. It is suggested that inhibition of hepatic microsomal enzyme activity may prevent thiopental's metabolism to its major metabolite, a carboxylic acid analogue, and increase the amount of thiopental desulfurated to pentobarbital. Inhibition of hepatic microsomal metabolism also decreases the metabolism of pentobarbital. Until further elucidation of the causes of altered thiopental metabolism is available to identify patients more likely to have elevated concentrations of pentobarbital, monitoring of blood drug concentrations in patients receiving thiopental should include determination of both thiopental and pentobarbital concentrations.

Adult↗
PubMed1986

Detection of cannabinoids in homicide victims and motor vehicle fatalities.

A gas chromatographic/mass spectrometric (GC/MS) procedure is described for the detection and measurement of delta 9-tetrahydrocannabinol, 11-hydroxy-delta 9-tetrahydrocannabinol, and 11-nor-delta 9-tetrahydrocannabinol-9-carboxylic acid in blood, or 11-nor-delta 9-tetrahydrocannabinol-9-carboxylic acid in urine. About 50% of all homicide victims and motor vehicle drivers killed in Bexar County in 1985 were tested for the presence of cannabinoids. Of 130 homicides and 69 drivers tested, blood was analyzed primarily in all but 15 and 3 cases, respectively. In these latter cases, blood analyzed after urine was found to be positive. Of the homicide victims, 44 (34%), and of all drivers, 19 (28%), tested were positive for one or more of the cannabinoids. As a separate group, 16 motorcycle drivers tested had 38% positive as compared with 25% of the other vehicle drivers. Ethyl alcohol was present in 55% of the drivers, and in 63% of the homicide victims. Drugs other than alcohol or cannabinoids were found in 10% of the drivers, and in 12% of the homicide victims.

Accidents, Traffic↗
PubMed1984

Two cases of death involving dicyclomine in infants. Measurement of therapeutic and toxic concentrations in blood.

In two deaths of infants investigated by the Medical Examiner, high levels of dicyclomine were detected in blood. In one of the cases, a level of 0.505 micrograms/ml was found, nearly 10 times reported adult therapeutic blood concentrations, and death was ascribed to an overdose of dicyclomine. Gas chromatography/mass spectrometry was used for the analysis of biological specimens.

Adult↗
PubMed1984

Metabolism of acetone to isopropyl alcohol in rats and humans.

Isopropyl alcohol and acetone have been detected in autopsy blood samples of individuals not previously exposed to these compounds. Since some of these individuals had a history of diabetes mellitus, it has been suggested that in these cases, reduction of acetone to isopropyl alcohol might be a metabolic pathway for its production. This hypothesis was investigated in a study of normal and diabetic rats. Acute administration of acetone resulted in measureable levels of isopropyl alcohol in blood. Metabolism of acetone to isopropyl alcohol was different in normal and diabetic animals. Blood levels of isopropanol reached a maximum at the second highest dose in normal rats, but there was a two-phase response in diabetic rats. In a second series of experiments, acetone was administered on alternate days for a week. In spite of this chronic administration (and persistence of high blood acetone), there was no enhancement of acetone metabolism to isopropyl alcohol. These experiments indicate that high levels of blood acetone could result in transformation to isopropyl alcohol.

1-Propanol↗
PubMed1983

A fatal case of lead poisoning due to a retained bullet.

Lead poisoning from a retained bullet or missile is rare and is usually dependent on the location of the missile in a bone or immediately adjacent to a joint. A review of the literature revealed only 14 cases in which there was adequate laboratory documentation of plumbism caused by a retained bullet or missile. Only one of these previously reported cases resulted in death. We report a second death due to lead poisoning from a retained bullet with elevated blood lead levels documented by toxicologic analysis.

Female↗
PubMed1983

Detection of marihuana use by GC/MS analysis of mouth swabs.

A relatively simple and rapid test for detection of the components of Cannabis sativa (marihuana) after smoking consists of swabbing the exposed areas with an alcohol-containing swab, then concentrating the extract from the swab for direct analysis by Gas Chromatography-Mass Spectrometry. This test is now performed in several medical examiner's offices. This study was performed to evaluate this test using volunteer marihuana-smoking subjects. Caution must be used in interpreting the results obtained because of the transient nature of the intoxication, and because of the possibility of obtaining false-positive results. The time response and other parameters concerning the procedure are also discussed.

Cannabis↗
PubMed1983

Chlorpromazine excretion by the neonate following chronic in utero exposure.

The pharmacokinetics of chlorpromazine in the newborn have not been reported. We studied the kinetics of removal of chlorpromazine from plasma in an infant whose mother was treated with high doses of chlorpromazine and lithium throughout the last trimester of pregnancy. The infant exhibited symptoms of severe neurologic depression that slowly abated over the first 9 days of life. The kinetics of plasma chlorpromazine removal were described with a two-compartment model, exhibiting a rapid half-life of 1.46 days and a slow half-life of 3.19 days. Both half-lives are considerably longer than the rapid and slow half-lives described in adults. Caution in exposing the fetus or newborn to chlorpromazine is warranted. Further information on the distribution and excretion of chlorpromazine by the newborn is needed.

Adult↗
PubMed1982

Death in the dental chair: three drug fatalities in dental patients.

Three patients, consisting of a seven year old boy and two adult women, died after administration of presurgical anesthetic medication in an oral surgeon's office. Toxicological analysis for the drugs involved and medical records confirmed the three individuals had all received potentially lethal doses of pentazocine, a narcotic analgesic, along with unusually high and potentially lethal doses of diazepam. All had also received anesthetic doses of methohexital, au ultra-short acting barbiturate and general anesthetic. Doxapram, a respiratory stimulant, was given in all cases without beneficial effect, and caffeine was administered in one case. Narcotic antagonists were not administered in any of the cases. Use of such could very well have prevented death in these cases.

Adult↗