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91 Z. Rechtsmedizin 1 (1983-1984)

handle is hein.journals/injlegame91 and id is 1 raw text is: Zeitschrift fur
Z Rechtsmed (1983) 91:1-15                            Rechtsmedizin
© Springer-Verlag 1983
Originalarbeiten / Original Works
Kiassifizierung von Digoxin-Blut- und Gewebekonzentrationen
bei Vergiftungsverdacht***
W. Hardle und R. Aderjan2
tUniversitat Heidelberg, Sonderforschungsbereich 123, Im Neuenheimer Feld 293,
D-6900 Heidelberg 1, Bundesrepublik Deutschland
2Universitat Heidelberg, Institut fur Rechtsmedizin, D-6900 Heidelberg 1,
Bundesrepublik Deutschland
Classification of the Digoxin Concentration in Blood and Tissues
in Cases Under Suspicion of Poisoning
Summary. The clarification of a suspicion of poisoning at all times poses a
problem to the forensic toxicologist, when a narrow margin of therapeutic
safety and a low dosage coincide as in cases of digoxin poisoning. Statistical
methods may serve as an aid. The post mortem digoxin concentration in the
tissues of heart, kidney, liver and in blood of 45 patients who had received
therapeutic daily doses and of 13 cases of fatal poisoning are compared.
After logarithmic transformation of the individual concentration values a
two modal distribution is obtained. There is one concentration calculated
with equal probability of being classified to therapeutic or toxic, as well as
the probability of observing the critical concentrations of 400 ng digoxin/g
cardiac tissue, 500 ng/g kidney and 250 ng/g liver after therapeutic dosing.
Using the discriminant analysis each of the cases clearly falls into one of
the two collectives therapeutic and toxic, when taken as a separate obser-
vation. Concentration data of fatal poisonings taken from the literature are
as successfully classified as the analytical results of some exhumed bodies
under suspicion but not poisoned. As expected the power of discrimination
increases with the number of parameters. Because of the relativly slow body
distribution of digoxin the blood taken from peripheral vessels is of most
important evidence.
Key words: Digoxin, tissue distribution - Poisoning, digoxin
* Diese Arbeit wurde z.T. durch Mittel der Deutschen Forschungsgemeinschaft, SFB 123
,,Stochastische Mathematische Modelle, unterstiitzt
** Frau Prof. Dr. Dr. M. Geldmacher-v. Mallinckrodt in Verehrung und Dankbarkeit ge-
widmet
Sonderdruckanfragen an: Dr. R. Aderjan (Adresse siehe oben)

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