Journal Published Online: 01 November 2003
Volume 48, Issue 6

Pharmacogenomics as an Aspect of Molecular Autopsy for Forensic Pathology/Toxicology: Does Genotyping Serve as an Adjunct for Certifying Methadone Toxicity?

CODEN: JFSCAS

Abstract

Pharmacogenomics, applied as an aspect of molecular autopsy, may be used as an adjunct for certifying methadone fatalities. Methadone is metabolized by cytochrome P-450 (CYP) 1A2, 3A4, and 2D6. We hypothesized that methadone toxicity may be partially due to CYP 2D6 *3, *4, and *5 variant alleles, resulting in poor drug metabolism. A retrospective analysis was performed on covariables and risk factors of 21 methadone cases from the Milwaukee County Medical Examiner's Office (1998–2000). PCR genotyping showed: one heterozygous for 2D6*3, two homozygous for 2D6*4, five heterozygous for 2D6*4, and one heterozygous for both 2D6*3 and *4. This limited number of cases showed that the prevalence of poor metabolizer was higher but not significantly different from that of a control group (n = 23) (P > 0.05, Fisher Exact Test). Thus, CYP 2D6 mutations may not yet be directly associated with methadone toxicity. However, pharmacogenomics, complementing other case findings, served as an adjunct in interpreting methadone toxicity of poor and intermediate metabolizers.

Author Information

Wong, SH
Milwaukee County Medical Examiners' Office, Milwaukee, WI Medical College of Wisconsin, Milwaukee, WI
Wagner, MA
Milwaukee County Medical Examiners' Office, Milwaukee, WI Medical College of Wisconsin, Milwaukee, WI
Jentzen, JM
Milwaukee County Medical Examiners' Office, Milwaukee, WI Medical College of Wisconsin, Milwaukee, WI
Schur, C
Medical College of Wisconsin, Milwaukee, WI
Bjerke, J
Medical College of Wisconsin, Milwaukee, WI
Gock, SB
Milwaukee County Medical Examiners' Office, Milwaukee, WI Medical College of Wisconsin, Milwaukee, WI
Chang, C
Medical College of Wisconsin, Milwaukee, WI
Pages: 10
Price: $25.00
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Stock #: JFS2002392
ISSN: 0022-1198
DOI: 10.1520/JFS2002392