Robertson M D, McMullin M M
National Medical Services, Inc., Willow Grove, PA 19090, USA.
J Forensic Sci. 2000 Mar;45(2):418-21.
The concentration of olanzapine (Zyprexa) was determined in 1653 clinical serum specimens during routine drug monitoring, and in 58 postmortem whole blood specimens as part of routine toxicological analysis. The analysis of olanzapine was performed by the solid-phase extraction of 1.0 mL of buffered serum or blood, followed by gas chromatography separation with nitrogen-phosphorus detection. The analysis of the clinical serum samples showed that 86% of positive serum values were within the range of 5 to 75 ng/mL, with a mean and median of 36 and 26 ng/mL, respectively. These data suggest that the concentrations of olanzapine expected during therapy may be higher than those previously reported. In 58 postmortem whole blood specimens the mean olanzapine concentration was 358 ng/mL with a range of 10 to 5200 ng/mL. Further, investigation of deaths involving olanzapine suggest that potential toxicity should be considered at concentrations above 100 ng/mL. Although the majority of the olanzapine-related deaths were associated with many other drugs, death primarily due to olanzapine toxicity was determined at concentrations in post-mortem blood as low as 160 ng/mL.
在常规药物监测期间，对1653份临床血清标本中的奥氮平（再普乐）浓度进行了测定，并在58份尸检全血标本中作为常规毒理学分析的一部分进行了测定。奥氮平的分析是通过对1.0 mL缓冲血清或血液进行固相萃取，然后进行气相色谱分离并采用氮磷检测来完成的。临床血清样本分析表明，86%的阳性血清值在5至75 ng/mL范围内，平均值和中位数分别为36 ng/mL和26 ng/mL。这些数据表明，治疗期间预期的奥氮平浓度可能高于先前报道的浓度。在58份尸检全血标本中，奥氮平的平均浓度为358 ng/mL，范围为10至5200 ng/mL。此外，对涉及奥氮平的死亡病例的调查表明，浓度高于100 ng/mL时应考虑潜在毒性。尽管大多数与奥氮平相关的死亡与许多其他药物有关，但在尸检血液中低至160 ng/mL的浓度下也确定了主要由奥氮平毒性导致的死亡。
