Methods

Before a toxicological analysis is performed, the physician and the analytical toxicologist should discuss the following points ( Lheureuxei a/ 1995).

1. Which substance (the parent compound and/or the metabolite(s)) should be analyzed and in what biological sample(s)?

2. What type of analytical method (qualitative or quantitative) and what specificity are needed?

3. Is the analysis useful for the management of the patient?

4. Within what time limit should the results be available for the physician?

A qualitative or semiquantitative analysis of the parent compound (or the active or non-active metabolites) may be adequate for diagnostic assessment. A quantitative analysis of the parent compound is mandatory for kinetic studies. Analysis of the parent compound and the active metabolite(s) is needed for toxicodynamic assessment (symptom-concentration relationship) (Jaegerefal 1994; kh§U^§UX..ef..a/ 1995). For instance, in ethylene glycol poisoning, analysis of ethylene glycol concentrations is useful for the diagnosis, but glycolate concentrations are more relevant for the evaluation of the severity and prognosis. Therefore the analytical toxicologist should be precisely informed about the indications and the objective of the analysis.

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