Distribution of Oxycodone in Postmortem Fluids and Tissues

摘要

Oxycodone is a heavily used and abused analgesic agent. Its pharmacological effects, including euphoria, respiratory depression, nausea, and drowsiness, have the potential to adversely affect performance. The postmortem distribution of oxycodone has not been well characterized, particularly at sub-lethal levels. Therefore, an attempt was made to evaluate the distribution of oxycodone in postmortem specimens collected from aviation accidents. Methods: A search of our database identified 4 oxycodone-positive fatalities from separate civil aviation accidents that occurred during a period of 6 years that had numerous biological tissues and fluids available (blood, urine, vitreous humor, liver, kidney, skeletal muscle, lung, spleen, heart muscle, and brain). These specimens were extracted using solid-phase extraction and were analyzed for oxycodone by GC/MS. Results: Oxycodone concentration ranges ( g/mL, g/g) found in the different tissues and fluids were: blood 0.027- 0.742, urine 2.20 - 12.5, vitreous humor 0.048 - 0.118, liver 0.103-3.35, lung 0.047-1.35, kidney 0.045-3.12, spleen 0.115-2.43, muscle 0.017-0.400, brain 0.032-1.36, and heart 0.038-3.19. Conclusion: The blood concentrations found indicate that the oxycodone in these cases ranged from therapeutic to above therapeutic, but all were below lethal levels. Tissue/fluid to blood distribution coefficients were found to have large coefficients of variation (ranging from 26-128%), thereby rendering them unreliable for estimating a blood oxycodone concentration from a tissue value when no blood is available for analysis.