NCJ Number
182838
Journal
Forensic Examiner Volume: 8 Issue: 11-12 Dated: November/December 1999 Pages: 137-167
Editor(s)
Daphne Greenlee
Date Published
1999
Length
4 pages
Annotation
This article discusses types of legal cases in which drug interactions are relevant, factors to consider when reviewing a case involving a drug interaction, examples of drug interactions, and clinical management of drug interactions.
Abstract
Drug interactions may be relevant in malpractice litigation, death or injury related to alleged intoxication, driving under the influence, homicides, suicides, and drug testing. Physicians, pharmacists, and nurses may be liable for failure to detect drug interactions. Further, drug interactions are relevant to substance abuse forensic work, and drug interactions need to be considered in death and suicide investigations. In analyzing drug interactions, forensic examiners should be careful when interpreting drug levels that are above or below the therapeutic range, especially since certain patients require higher or lower levels than the standard therapeutic range. Specific drug interactions are described for astemizole, monoamine oxidase inhibitors, serotonin, HIV protease inhibitors, theophylline, and ethanol. Four considerations in managing drug interactions are identified: (1) certain combinations of drugs are contraindicated and should never be given concurrently; (2) many drug interactions can easily be circumvented; (3) alternative drugs with less risk of interaction should be used; and (4) patient risk should be assessed and precautions should be taken to avoid adverse outcomes. 26 references