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Biomedical subjects

R Mattern

Publications and source records attributed to R Mattern.

At least 55 records · Page 3Linked to original sources
PubMed1980

[Validity of digoxin concentrations in blood determined post mortem (author's transl)].

The digoxin concentration in the blood of ten patients with terminal illness were determined by radioimmunoassay sampling the specimens 10-30 min before death, 30 min after death (subclavial catheter), and at autopsy (femoral vein and heart). At autopsy increased levels were found: in heart blood 6.64 +/- 4.45 ng/ml, in femoral vein blood 4.42 +/- 2.45 ng/ml, in ante mortem vein blood 3.36 +/- 1.75 ng/ml, mean difference in vein blood: 1.06 +/- 0.79 ng/ml (mean value and standard deviation). Only the corresponding concentration values in vein blood are closely correlated. The increase is determined statistically significant by the initial concentration found before death. A gradient dependent diffusion back from the tissues surrounding the vessels is to be considered. The walls of the vessels, however, do not contain higher digoxin concentration than the blood. Six of the ten cases showed levels of digoxin in the ante mortem blood clearly above the therapeutic range of 0.5-2.0 ng/ml. Reasons for this observation are discussed.

Digoxin↗
PubMed1980

[On determination and pharmacokinetics of flurazepam metabolites in human blood (author's transl)].

The blood levels and the elimination kinetics of flurazepam and its major metabolites in blood were investigated in 10 volunteers after application of 60 mg flurazepam (Dalmadorm). Hydroxyethylflurazepam and desalkylflurazepam are the metabolites suitable for proving a previous flurazepam ingestion. Splitting of glucuronides is helpful for the determination of hydroxyethylflurazepam as the maximum blood concentration of the unconjugated metabolite does not exceed 1/3 of the concentration after glucuronidase splitting. Because of the different half-lives of formation and of elimination a characteristic time dependent pattern of flurazepam and its metabolites is observed in blood during 24 h after a single dosing. From this, conclusions may be drawn about the period of time between ingestion and sampling of the blood specimen. The accumulation of desalkylflurazepam is indicative of the dose applied or of previous multiple dosing. Parallel to the rise of the blood concentration of the metabolites the excretion of the corresponding hydroxyethylflurazepam glucuronide is detectable in urine. Within 30 min the concentrations are suitable for thin-layer chromatographic quantitation. An impaired performance of the volunteers was observed essentially during the absorption and the early distribution phase.

Blood Pressure↗
PubMed1979

[A fatal monointoxication by flurazepam (Dalmadorm). Problems of the toxicological interpretation (author's transl)].

A death case following a suicidal overdose of flurazepam (Dalmadorm) is reported. The body was found after 3 month near a highway. The course of the intoxication is in question as benzodiazepines are believed to be relatively save drugs. The death might have occured rapidly because of the acute toxic actions of the drug overdose as well as after a protracted course involving additional complications like inflammatory alteration of the myocard or hypothermia during a coma. Flurazepam and its major metabolites were analysed in blood and urine. The toxic levels of flurazepam (0.51 mg/l), N1-desalkylflurazepam (0.14 mg/1) and N1-hydroxyethylflurazepam (9.0 mg/1) in the blood amounted to 20--50 times higher than therapeutic levels, with flurazepam and metabolites being in only slight altered relation to each other. The overdose is considered to have been above 2.4 g (80 tablets). The resorption of the drug was complete. The analytical findings in blood and urine as well as in the GI-tract are in satisfactory agreement. The analytical data of flurazepam and its metabolites are discussed in detail, taking metabolic and pharmacokinetic parameters, autopsy findings and case circumstances into consideration. A final decision about the course of the intoxication is not possible. This case shows however the fatal consequences of a flurazepam overdose although alcohol or other drugs were not involved.

Autopsy↗