Toxicological Assessment of Barbiturates: Analytical Methods, Metabolism, and Forensic Implications in Drug-related Fatalities
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Abstract
Barbiturates, once commonly prescribed for their sedative and anticonvulsant properties, have since fallen out of widespread therapeutic use due to their narrow therapeutic index and high risk of fatal overdose. Despite this decline, they remain critical in forensic toxicology, particularly in drug-related fatalities. This review explores the toxicological assessment of barbiturates, focusing on their mechanisms of action, metabolism, and the forensic implications in cases of overdose. The paper delves into the pharmacodynamics of barbiturates, highlighting their central nervous system (CNS) depressant effects through GABAergic modulation, dose-dependent toxicity, and the resulting cardiovascular and respiratory depression that often leads to fatal outcomes. Furthermore, the review discusses both historical and modern analytical methods employed in forensic toxicology for barbiturate detection, including gas chromatography-mass spectrometry (GC-MS) and liquid chromatography-tandem mass spectrometry (LC-MS/MS). Special attention is given to challenges in interpreting toxicological data, such as postmortem redistribution and polydrug interactions, which complicate forensic investigations. By examining the role of barbiturates in modern forensic toxicology, this paper underscores their ongoing relevance in forensic cases involving drug-induced fatalities.
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