title: Comparison of drug concentrations in postmortem cerebrospinal fluid and blood specimens.
abstract: The concentration of drugs and metabolites in cerebrospinal fluid (CSF) and blood were determined in 282 autopsied cases using liquid-liquid extraction techniques and gas chromatographic analyses. All drugs were confirmed in one matrix by gas chromatography-mass spectrometry. CSF/blood ratios were used to compare the two biological fluids. Classes of drugs evaluated in this study included: benzodiazepines, anticonvulsants, sedatives, opioids, antidepressants, anesthetics, and antihistamines. The majority of the drugs tested were readily detected in CSF specimens. The average CSF/blood ratio for most drugs was in the range of 0.05-0.50. Interpretation of these results is difficult because protein binding, half-life, hydrophobic properties, and pKa of a drug, in addition to survival time after drug use, influence the CSF/blood ratio. While CSF specimens do provide a viable alternative testing matrix when blood specimens are not available, they should not be used to estimate blood drug concentrations.
authors: Omega Laboratories Inc., Mogadore, Ohio 44260, USA.
authors: David A
authors: DA
authors: Engelhart
authors: Amanda J
authors: AJ
authors: Jenkins
mesh_terms: D000701:Analgesics, Opioid / Q000097:blood / Q000134:cerebrospinal fluid; D000777:Anesthetics / Q000097:blood / Q000134:cerebrospinal fluid; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000097:blood / Q000134:cerebrospinal fluid; D000927:Anticonvulsants / Q000097:blood / Q000134:cerebrospinal fluid; D000928:Antidepressive Agents / Q000097:blood / Q000134:cerebrospinal fluid; D001344:Autopsy; D001569:Benzodiazepines / Q000097:blood / Q000134:cerebrospinal fluid; D006634:Histamine H1 Antagonists / Q000097:blood / Q000134:cerebrospinal fluid; D006801:Humans; D006993:Hypnotics and Sedatives / Q000097:blood / Q000134:cerebrospinal fluid; D004364:Pharmaceutical Preparations / Q000097:blood* / Q000134:cerebrospinal fluid*
chemical_list: D000701:Analgesics, Opioid; D000777:Anesthetics; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000927:Anticonvulsants; D000928:Antidepressive Agents; D006634:Histamine H1 Antagonists; D006993:Hypnotics and Sedatives; D004364:Pharmaceutical Preparations; D001569:Benzodiazepines