l Toxicology & Pharmacology, Newcastle Mater Misericordiae Hospital In Excess – Death and In Excess – Death and Toxicology Toxicology The interface between clinical toxicology, forensic The interface between clinical toxicology, forensic sciences and the law sciences and the law Dr Ian Whyte, FRACP Hunter Area Toxicology Service
36
Embed
In Excess – Death and Toxicology The interface between clinical toxicology, forensic sciences and the law
In Excess – Death and Toxicology The interface between clinical toxicology, forensic sciences and the law. Dr Ian Whyte, FRACP Hunter Area Toxicology Service. Clinical Toxicology. Medical specialty concerned with the effects of drugs and toxins (poisons) on humans paediatricians - PowerPoint PPT Presentation
Welcome message from author
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
Clinical Toxicology & Pharmacology, Newcastle Mater Misericordiae Hospital
In Excess – Death and Toxicology In Excess – Death and Toxicology
The interface between clinical toxicology, forensic sciences and the lawThe interface between clinical toxicology, forensic sciences and the law
Dr Ian Whyte, FRACPHunter Area Toxicology Service
Clinical Toxicology & Pharmacology, Newcastle Mater Misericordiae Hospital
Clinical ToxicologyClinical Toxicology
Medical specialty concerned with the effects of drugs and toxins (poisons) on humans– paediatricians – accident and emergency specialists– occupational physicians– clinical pharmacologists
Clinical Toxicology & Pharmacology, Newcastle Mater Misericordiae Hospital
Paracelsus Paracelsus (1493–1541)(1493–1541)
All substances are poisons; there is none which is not a poison. The right dose differentiates a poison and a remedy
Justice is like poison; whether it kills or heals depends on the dosage
Stephen J. Nardi, US criminal defence lawyer
– http://www.nocolpa.com/quotes.html
Clinical Toxicology & Pharmacology, Newcastle Mater Misericordiae Hospital
MLE MLE (32 years old)(32 years old)
Alcoholic father killed his mother (MVA) when he was 3
State ward in multiple institutions with repeated physical and sexual abuse
Cerebral aneurysm rupture in 1988– on carbamazepine (Tegretol) for seizures
Alcoholic for 15 years – 18–36 cans of beer a day
Clinical Toxicology & Pharmacology, Newcastle Mater Misericordiae Hospital
On arrival at hospitalOn arrival at hospital
19/7/94 1440 hours– Arrived by ambulance– Found unconscious in police cell– No response to Naloxone– ? Stroke, ? Drug overdose– Unconscious
Coma level 2 Glasgow coma scale 3/15
Clinical Toxicology & Pharmacology, Newcastle Mater Misericordiae Hospital
Glasgow coma scaleGlasgow coma scale
Developed in Scotland to help predict long term outcome of head injury
Clinical Toxicology & Pharmacology, Newcastle Mater Misericordiae Hospital
Carbamazepine (PJS)Carbamazepine (PJS)
0
50
100
150
200
250
300
0 10 20 30 40 50 60
Hours from overdose
Con
cent
ratio
n (µ
mol
/L)
Clinical Toxicology & Pharmacology, Newcastle Mater Misericordiae Hospital
HATS databaseHATS database
Database began 13/1/1987 We have had 6125 admissions Of these, 5181 were for deliberate self
harm (drug overdose) Of these, 117 were for overdose of
carbamazepine Of these, 2 (1.7%) died Overall 32 of 5181 (0.6%) died
Clinical Toxicology & Pharmacology, Newcastle Mater Misericordiae Hospital
ParacelsusParacelsus
All things are poisons, and nothing is without toxicity. Only the dose permits anything not to be poisonous. For example, every food and every drink is a poison if consumed in more than the usual amount: which proves the point. I admit that a poison is a poison; but that is no reason for condemning it outright
Clinical Toxicology & Pharmacology, Newcastle Mater Misericordiae Hospital
Paracelsus HealthcareParacelsus Healthcare
Paracelsus Healthcare Corp. will pay $3 million to settle allegations that the hospital chain ran a revolving door drug rehabilitation clinic where some patients never saw a physician, said the U.S. Justice Department