Principles and procedures in forensic toxicology.

Toxicology Department, Cuyahoga County Region Forensic Science Laboratory, Cuyahoga County Medical Examiner's Office, 11001 Cedar Avenue, Cleveland, OH 44106, USA. jfwyman@cuyahogacounty.us

Clinics in laboratory medicine 2012 Sep

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The principles and procedures employed in a modern forensic toxicology lab are detailed in this review. Aspects of Behavioral and Postmortem toxicology, including certification of analysts and accreditation of labs, chain of custody requirements, typical testing services provided, rationale for specimen selection, and principles of quality assurance are discussed. Interpretation of toxicology results in postmortem specimens requires the toxicologist and pathologist to be cognizant of drug-drug interactions, drug polymorphisms and pharmacogenomics, the gross signs of toxic pathology, postmortem redistribution, confirmation of systemic toxicity in suspected overdoses, the possibility of developed tolerance, and the effects of decomposition on drug concentration.