Sağlık Sektöründe En Çok Kötüye Kullanılan İlaçlardan Biri Olan Petidin Üzerine Kapsamlı Bir İnceleme
DOI:
https://doi.org/10.17986/blm.1727Anahtar Kelimeler:
Aldolan- ilaç suistimali- BağımlılıkÖz
İnsanlarda ağrı tedavisinde kullanılan petidin (PET), kötüye kullanımıyla da dikkat çeken kontrole tabi bir ilaçtır. Bu ilacı ağrı kesici olarak kullandığını bildiren bir kişinin ilacı kötüye kullanma niyetinde mi yoksa tedavi amaçlı mı kullandığını anlamak da oldukça güçtür. PET kullanımını sınırlama ve ikame seçenekleri keşfetme çabaları olmasına rağmen PET’in kötüye kullanımı halen artmaktadır. Günümüz itibari ile Türkiye’nin çeşitli illerindeki eczacı odaları PET suistimali konusunda yüzlerce bildiri yayınlamıştır. PET bağımlılığı, kişinin yanı sıra toplumu ve içinde yaşadıkları çevreyi de etkileyen bir halk sağlığı sorunudur. Bu ilacın kötüye kullanımı en çok sağlık sektöründe görülmektedir, bu da durumun ciddiyetinin daha da arttırmaktadır. Bunun sebebinin ise uzun ve stresli çalışma hayatı ve bu ilaçlara kolay erişimin olmasından kaynaklandığı düşünülmektedir. PET, neden olduğu veya ürettiği etkiler nedeniyle hem klinik hem de adli öneme sahiptir. Bu derlemenin amacı, PET’in genel özelliklerini, farmakokinetiğini, farmakolojisini, yan etkilerini, adli önemini, analitik tespit tekniklerini ve bağımlılığını önleme çalışmalarını gözden geçirmektir. Bu bağlamda, bu derlemenin PET’in kötüye kullanımının tehlikelerine dikkat çekeceğine, PET bağımlılığının yol açtığı bireysel ve toplumsal sorunlara ışık tutacağına ve bu sorunların çözümüne bir nebze de olsa yardımcı olacağı düşünülmektedir. olacağına inanıyoruz.
İndirmeler
Kaynaklar
NIDA. Opioids. National Institute on Drug Abuse website. https://nida.nih.gov/research-topics/opioids. November 22, 2024 Accessed November 22, 2024.
Vadivelu N, Kai AM, Kodumudi V, Sramcik J, Kaye AD. The Opioid Crisis: a Comprehensive Overview. Curr Pain Headache Rep. 2018, 22(3). https://doi.org/10.1007/s11916-018-0670-z
Holstege CP, Borek HA. Toxidromes. Crit. Care Clin. 2012, 28(4), 479-498. https://doi.org/10.1016/j.ccc.2012.07.008
Kee WN. Epidural pethidine: pharmacology and clinical experience. Anaesth Intensive Care. 1998, 26(3), 247-255. https://doi.org/10.1177/0310057X9802600303
Maila B, Tsarkov A, Petlovanyi P, Kweku G, Musonda E. Treatment of Opioid Use Disorder With Buprenorphine-Naloxone at Chainama Hills College Hospital in Lusaka, Zambia: A Case Report. EJMED. 2020, 2(4), 1-3. http://dx.doi.org/10.24018/ejmed.2020.2.4.413
Evren C, Karabulut V, Can Y, Bozkurt M, Umut G, Evren B. Predictors of outcome during a 6-month follow-up among heroin dependent patients receiving buprenorphine/naloxone maintenance treatment. KLIN PSIKOFARMAKOL B. 2014, 24(4), 311-322. https://doi.org/10.5455/bcp.20140310072258
European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). European Drug Report, 2021, Trends and Developments. Luxembourg: Publications Office of the European Union. Accessed: https://www.emcdda.europa.eu/publications/edr/trends-developments/2021_en. (16 March 2022).
Dydyk AM, Jain NK, Gupta M. Opioid Use Disorder. [Updated 2024 Jan 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK553166/
Gallen B, Prescott F. Pethidine as an obstetric analgesic. Br Med J. 1944, 1(4335), 176. doi: 10.1136/bmj.1.4335.176
Cousins M, Mather L, Glynn C, Wilson P, Graham J, Samii K, Feret J, Harari A, Viars, P. Selective spinal analgesia. Lancet, 1979, 313(8126), 1141–1142. https://doi.org/10.1016/S0140-6736(79)91817-8
Robinson C, Howie LA. Non-neuraxial analgesia in labour. Anaesth Intensive Care. 2019, 20(7), 367-370. https://doi.org/10.1016/j.mpaic.2019.04.007
Fleet JA. A Comparison of Intranasal Fentanyl, Subcutaneous Fentanyl and Intramuscular Pethidine during Childbirth: A Randomised Controlled Trial [Doctoral dissertation]. Flinders University, School of Nursing & Midwifery. 2015.
Bricker L, Lavender T. Parenteral opioids for labor pain relief: a systematic review. AJOG. 2002, 186(5), S94-S109. https://doi.org/10.1016/S0002-9378(02)70185-3
Cheng IC, Chang CS, Tsay WI. Long-term usage of narcotic analgesics by chronic intractable noncancer pain patients in Taiwan from 2003 to 2012. JFMA. 2016, 115(9), 773-778. https://doi.org/10.1016/j.jfma.2015.08.001
Aghdam AM, Rousta F. Investigating the Effects of Pethidine on Hemodynamic Status after Completion of Laparotomy Surgery. Eur. J. Chem. Med. Petrol. Res. 2022, 1(4), 175-188.
Jaafarpour M, Taghizadeh Z, Shafiei E, Vasigh A, Sayehmiri K. The effect of intrathecal meperidine on maternal and newborn outcomes after cesarean section: a systematic review and meta-analysis study. Anesth Pain Med. 2020, 10(2). https://doi.org/10.5812/aapm.100375
Malm H, Borisch C. Analgesics, non-steroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, and antigout medications. In Drugs during pregnancy and lactation. Academic Press, 2015, pp. 27-58.
United Nations Office On Drugs; Crime. World drug report. 2019.
Quaglia MG, Farina A, Donati E, Cotechini V, Bossu E. Determination of MPTP, a toxic impurity of pethidine. J. Pharm. Biomed. Anal. 2003, 33(1), 1-6. https://doi.org/10.1016/S0731-7085(03)00256-5
Lewis J, Shimmon R, Fu S. Pethidinic acid: corroboration of a doctor's denial of pethidine re-use. J. Anal. Toxicol. 2013, 37(3), 179-181. https://doi.org/10.1093/jat/bkt003
Kintz P, Godelar B, Mangin P, Lugnier AA, Chaumont AJ. Simultaneous determination of pethidine (meperidine), phenoperidine, and norpethidine (normeperidine), their common metabolite, by gas chromatography with selective nitrogen detection. Forensic Sci. Int. 1989,43(3), 267-273. https://doi.org/10.1016/0379-0738(89)90154-0
Morgan GE, Mikail MS, Murray MJ. Clinical anesthesiology. 2002.
Stanley TH. The history and development of the fentanyl series. J Pain Symptom Manage. 1992, 7(3), S3-S7. https://doi.org/10.1016/0885-3924(92)90047-L
Hansen MS, Mathiesen O, Trautner S, Dahl JB. Intranasal fentanyl in the treatment of acute pain–a systematic review. Acta Anaesthesiol. Scand. 2012, 56(4), 407-419. https://doi.org/10.1111/j.1399-6576.2011.02613.x
Yasaei R, Rosani A, Saadabadi A. Meperidine. In StatPearls [Internet]. StatPearls Publishing. 2023. https://www.ncbi.nlm.nih.gov/books/NBK470362/
Vallejo R, Barkin RL, Wang VC. Pharmacology of opioids in the treatment of chronic pain syndromes. Pain physician, 2011, 14(4), E343.
Williams D. Subarachnoid Saddle Block using Pethidine, Practical Techniques In Developing Countries. Analgesia, 1987, 66: 235-40.
Nunes RR, Colares PGB, Montenegro JP. Is pethidine safe during labor? Systematic review. Rev Bras Ginecol Obstet. 2017, 39(12), 686-691. https://doi.org/10.1055/s-0037-1604065
Kredo T, Onia R. Pethidine-does familiarity or evidence perpetuate its use?: clinical practice: SAMJ forum. S. Afr. Med. J. 2005, 95(2), 100-101
Harvey SC, Toussaint CP, Coe SE, Watson EE, O’Neil MG, Patrick KS. Stability of meperidine in an implantable infusion pump using capillary gas chromatography–mass spectrometry and a deuterated internal standard. J. Pharm. Biomed. Anal. 1999, 21(3), 577-583. https://doi.org/10.1016/S0731-7085(99)00149-1
Ishii A, Tanaka M, Kurihara R, Watanabe-Suzuki K, Kumazawa T, Seno H, Suzuki O, Katsumata Y. Sensitive determination of pethidine in body fluids by gas chromatography–tandem mass spectrometry. J. Chromatogr. B. 2003, 792(1), 117-121. https://doi.org/10.1016/S1570-0232(03)00132-6
Buchan AS, Bauld HW. Blood-gas changes during trichloroethylene and intravenous pethidine anaesthesia. Br. J. Anaesth. 1973, 45(1), 93-99. https://doi.org/10.1093/bja/45.1.93
Todd EL, Stafford DT, Morrison JC. Determination of meperidine and normeperidine in serum by gas chromatography/mass spectrometry. J. Anal. Toxicol. 1979, 3(6), 256-259. https://doi.org/10.1093/jat/3.6.256
Misiołek H, Zajączkowska R, Daszkiewicz A, Woroń J, Dobrogowski J, Wordliczek J, Owczuk R. Postoperative pain management—2018 consensus statement of the section of regional anaesthesia and pain therapy of the polish society of anaesthesiology and intensive therapy, the polish society of regional anaesthesia and pain therapy, the polish association for the study of pain and the national consultant in anaesthesiology and intensive therapy. Anaesthesiol. Intensive Ther. 2018, 50(3). https://doi.org/10.5603/AIT.2018.0026
Chan K, Lau OW, Wong YC. Determination of pethidine and its major metabolites in human urine by gas chromatography. J. Chromatogr. B Biomed. Appl. 1991, 565(1-2), 247-254. https://doi.org/10.1016/0378-4347(91)80387-R
Bozdağ Z, Şamdancı ET, Şahin N, Aydın NE, Sayın S. Petidine Bağlı Ani Ölüm. Adli Tıp Derg. 2013, 27(1), 76-80.
Kang KH, Kuo LF, Cheng IC, Chang CS, Tsay WI. Trends in major opioid analgesic consumption in Taiwan, 2002–2014. J Formos Med Assoc. 2017, 116(7), 529-535. https://doi.org/10.1016/j.jfma.2016.09.004
Jamey C, Ludes B, Raul JS. Sensitive determination of pethidine and its metabolite in human hair by liquid chromatography-tandem mass spectrometry. Toxicol. Anal. Clin. 2014, 26(3), 165-168. https://doi.org/10.1016/j.toxac.2014.07.005
Raghu T. A Prospective, Randomized Clinical Trial For Comparison Of Pethidine And Dexmedetomidine For The Control Of Intraoperative Shivering Under Spinal Anaesthesia [Doctoral dissertation]. BLDE (Deemed to be University). 2018.
Kul A, Ozdemir M, Sagirli O. Determination of pethidine of abuse and relevant metabolite norpethidine in urine by ultra-performance liquid chromatography-tandem mass spectrometry. J Pharm Biomed Anal. 2020, 186, 113320. https://doi.org/10.1016/j.jpba.2020.113320
Austin KL, Stapleton JV, Mather LE. Rate of formation of norpethidine from pethidine. Br. J. Anaesth. 1981, 53(3), 255-258. https://doi.org/10.1093/bja/53.3.255
Shee JC. Dangerous potentiation of pethidine by iproniazid, and its treatment. Br. Med. J. 1960, 2(5197), 507. https://doi.org/10.1136/bmj.2.5197.507
Mehta N. Adjuvant drugs to local anesthetics. In Topics in Local Anesthetics. IntechOpen. 2020. https://doi.org/10.5772/intechopen.91980
Asatoor AM, London DR, Milne MD, Simenhoff ML. The excretion of pethidine and its derivatives. Brit. J. Pharmacol.1963, 20(2), 285-298 https://doi.org/10.1111/j.1476-5381.1963.tb01468.x
Holmberg L, Odar-Cederlöf I, Boreus LO, Heyner L, Ehrnebo M. Comparative disposition of pethidine and norpethidine in old and young patients. Eur. J. Clin. Pharmacol.1982, 22, 175-179. https://doi.org/10.1007/BF00542464
McQuay HJ, Moore RA. Opioid problems, and morphine metabolism and excretion. In The Pharmacology of Pain (pp. 335-360). Berlin, Heidelberg: Springer Berlin Heidelberg. 1997.
Houghton IT, Chan K, Wong YC, Leung DY, Aun CST. Biotransformation of pethidine: a comparative study of 24 h urine in three ethnic groups. Eur. J. Drug Metab. Pharmacokinet. 1993, 18, 285-288. https://doi.org/10.1007/BF03188810
Crawford JS, Rudofsky S. The placental transmission of pethidine. Br. J. Anaesth. 1965, 37(12), 929-933. https://doi.org/10.1093/bja/37.12.929
Trescot AM, Datta S, Lee M, Hansen H. Opioid pharmacology. Pain physician, 2008, 11(2S), S133.
Waldhoer M, Bartlett SE, Whistler JL. Opioid receptors. Annu. Rev. Biochem. 2004, 73(1), 953-990. https://doi.org/10.1146/annurev.biochem.73.011303.073940
Piltonen M, Parisien M, Grégoire S, Chabot-Doré AJ, Jafarnejad SM, Bérubé P, Djambazian H, Sladek R, Geneau G, Willett P, Stone LS, Shabalina SA, Diatchenko L. Alternative splicing of the delta-opioid receptor gene suggests existence of new functional isoforms. Mol Neurobiol. 2019, 56, 2855-2869. https://doi.org/10.1007/s12035-018-1253-z
Pergolizzi JV, Ossipov MH, Taylor R, Raffa RB. “New-Look” Opioids: Biased Ligands. Pharmacology & Pharmacy, 2018, 9(7), 242-249. https://doi.org/10.4236/pp.2018.97018.
Childers SR, Snyder SH. Guanine nucleotides differentiate agonist and antagonist interactions with opiate receptors. Life Sci. 1978, 23(7), 759-761. https://doi.org/10.1016/0024-3205(78)90077-2
Cuitavi J, Hipólito L, Canals M. The life cycle of the mu-opioid receptor. Trends Biochem Sci. 2021, 46(4), 315-328. https://doi.org/10.1016/j.tibs.2020.10.002
Torrecilla M, Quillinan N, Williams JT, Wickman K. Pre‐and postsynaptic regulation of locus coeruleus neurons after chronic morphine treatment: a study of GIRK‐knockout mice. Eur. J. Neurosci. 2008, 28(3), 618-624. https://doi.org/10.1111/j.1460-9568.2008.06348.x
Eisendrath SJ, Goldman B, Douglas J, Dimatteo L, Van Dyke C. Meperidine-induced delirium. Am J Psychiatry, 1987, 144(8), 1062-5.
Saxena S, Mohan D. Pentazocine abuse: review and a report on eighteen cases. Indian J. Psychiatry. 1985, 27(2), 149-152.
Arslan Z, Kartufan FF, Genc MK, Battal D, Yayla M, Turkmen Z. An analytical approach to determining pethidine: An investigation of 18 patients’ urine. J Pharm Biomed Anal. 2023, 235, 115670. https://doi.org/10.1016/j.jpba.2023.115670
Odokonyero R, Aujo T, Agaba D, Abbo C. Childhood adversity and co-dependency roles in a case of a midwife with pethidine use disorder attending Mulago National Referral Hospital, Kampala, Uganda. Cogent Public Health. 2022, 9(1), 2145704. https://doi.org/10.1080/27707571.2022.2145704
Ünsalan N, Kalyoncu A, Pektas Ö, Mirsal H, Beyazyürek M. Yatarak tedavi gören madde bagimliligi (alkol ve alkol disi) tanisi konan hekimlerin özellikleri/Characteristics of inpatient physicians diagnosed with substance use disorders (alcohol and other substances). Anadolu Psikiyatri Derg. 2004, 5(3), 148.
Annagür BB. A nurse with pethidine addiction. Eur. J. Gen. Med. 2012, 9(1).
Erkan İ, Erkan G, Bayram A. Substance Use Disorder and Addiction in Operating Room and Anesthesiology Workers. ORGANIZATION, MANAGEMENT AND EDUCATION IN ANESTHESIOLOGY AND OPERATING ROOM (pp.99-104), Ankara: Türkiye Klinikleri Yayınevi. 2022.
Kurt DT, Çakırca M. PANDEMİ DÖNEMİNDE AMELİYATHANE ÇALIŞANLARINDA TÜKENMİŞLİĞİN DEĞERLENDİRİLMESİ. Med J SDU. 2023, 30(1), 63-68. doi: 10.17343/sdutfd.1212361
Naldan ME, Karayağmurlu A, Yayık M, Arı MA. Ameliyathanede Çalışan Sağlık Profesyonellerinde Tükenmişlik, İş Doyumu ve Depresyon. Selcuk Med J. 2019, 35(3). DOI: 10.30733/std.2019.01117
Sadock BJ, Sadock VA. Kaplan & Sadock's concise textbook of clinical psychiatry. Lippincott Williams & Wilkins. 2008.
Kim J, Ji D, Kang S, Park M, Yang W, Kim E, Choi H, Lee S. Simultaneous determination of 18 abused opioids and metabolites in human hair using LC–MS/MS and illegal opioids abuse proven by hair analysis. J Pharm Biomed Anal. 2014, 89, 99-105. https://doi.org/10.1016/j.jpba.2013.10.041
Jeyaretnam J, Jones H, Phillips M. Disease and injury among veterinarians. Aust Vet J. 2000, 78(9), 625-629.
Reifenschweiler DOH. Pethidine abuse. Reactions, 2013, 1481, 28-7.
Frank M, Philipp KP, Matthes G, Bockholdt B, Ekkernkamp A. Lethal intoxication while driving a car. Arch.f.Krim. 2009, 224(1-2), 10-16.
Gibney L, Choudhury P, Khawaja Z, Sarker M, Vermund SH. Behavioural risk factors for HIV/AIDS in a low-HIV prevalence Muslim nation: Bangladesh. Int. J. STD AIDS. 1999, 10(3), 186-194. https://doi.org/10.1258/0956462991913862
Current Topics Etc. from Pethidine AD. Ind Med Gaz. 1947, Sep;82(9):560-567.
Evren EC, Ögel K, Çakmak D. Comperison the properties of inpatient meperidine (pethidine) and cannabis abusers. Anat J of Psych. 2002; 3 (1): 20, 7.
Pethidine abuse. Drug dependence and withdrawal syndrome: case report. React. Wkly. 2010, 1307, 37. https://doi.org/10.2165/00128415-201013070-00119
Daldrup T. A forensic toxicological dilemma: the interpretation of post-mortem concentrations of central acting analgesics. Forensic Sci. Int. 2004, 142(2-3), 157-160. https://doi.org/10.1016/j.forsciint.2004.02.016
Yan P, Huang G, Li D, Li L. Homicide due to intravenous metallic mercury injection followed by sodium cyanide injection. Am. J. Forensic Med. Pathol. 2012, 33(3), 273-275. https://doi.org/10.1097/PAF.0b013e318221b693
Bilici R. Pheniramine/diazepam/pethidine abuse. Reactions, 2013, 1458, 29.
Ahmadi J. Pethidine Abuse: A Novel Finding. J Addict De-pend. 2016, 2 (2): 1-3. Mini review.
Romer C. Acute Pethidine Poisoning. Br. Med. J. 1952, 2(4794), 1135. https://doi.org/10.1136/bmj.2.4794.1135
Pinkerton JRH, Rolfe DWM. Pethidine Poisoning. Br. Med. J. 1953, 1(4812), 728.
Alhamdan L, Qudaisat I, Alraqab A, Ahmed U. Recovery from serotonin syndrome after the use of propofol: 9AP2-10. Eur. J. Anaesthesiol. 2012, 29, 137.
Mbuvah F, Venur VA, Kistangari G. The Clinical Picture. Cleve Clin J Med. 2014, 81(4), 223. https://doi.org/10.3949/ccjm.81a.13082
Rozas-Muñoz E, García-Muret MP, Puig L. Chronic ulceration and fibrosis of the forearm. JAMA Dermatol. 2015, 151(3), 331-332. https://doi.org/10.1001/jamadermatol.2014.2826
Alha A, Karlsson M, Korte T. Fatal combined anileridine-pethidine poisoning. A gas chromatography, thin layer chromatography and mass spectrometry investigation. Z Rechtsmed. 1975, 75, 293-298. https://doi.org/10.1007/BF00201184
Karunatilake H, Buckley NA. “Severe neurotoxicity following oral meperidine (pethidine) overdose”. Clin. Toxicol. 2007, 45(2), 200-201. https://doi.org/10.1080/15563650600981194
George P, Ramasamy P, Thurairajasingam S, Shah Z. Patients that benefit from buprenorphine-naloxone on medically assisted treatment for opioid dependence in Malaysia. Med J Malaysia, 2015, 70(4), 251.
Yılmaz A, Noyan CO, Çetin A. “TILL PETHIDINE DO US APART”; ADDICTED HEALTHCARE PROFESSIONAL COUPLE. Curr. Addict. Res. 1(2), 75-77 https://doi.org/10.5455/car.105-1514925281
Yargıç İ. Sağlık çalışanlarında bağımlılıkla ilgili sorunlar ve çözüm yolları. Klinik Gelişim, 2009, 22(4), 84-87.
Özer Ü, Sever A, Çetin T, Evren C. Venlafaxine pharmacotherapy in meperidine addiction and chronic pain comorbidity: a case report. Dusunen Adam Journal of Psychiatry and Neurological Sciences, 2010, 23(1), 69. https://doi.org/10.5350/DAJPN2010230111t
Büyük Y, Üzün İ, Koçak U, Özer E. Sudden death of a health worker due to pethidine abuse: a case report. Turkiye Klinikleri J Foren Med. 2005, 19(1), 33-36.
Wang X, Xiang Z, Cai X, Wu H, Wang X, Li J, Zhang M. Determination of pethidine in human plasma by LC–MS/MS. Biomed. Chromatogr. 2011, 25(7), 833-837. https://doi.org/10.1002/bmc.1524
Lindberg C, Bondesson U, Hartvig P. Investigation of the urinary excretion of pethidine and five of its metabolites in man using selected ion monitoring. Biomed. Mass Spectrom. 1980, 7(2), 88-92. https://doi.org/10.1002/bms.1200070210
Álvarez-Sánchez B, Priego-Capote F, De Castro ML. Metabolomics analysis I. Selection of biological samples and practical aspects preceding sample preparation. TrAC, Trends Anal. Chem. 2010, 29(2), 111-119. https://doi.org/10.1016/j.trac.2009.12.003
Lindberg C, Berg M, Boréus LO, Hartvig P, Karlsson KE, Palmér L, Thörnblad AM. A selected ion monitoring method for the determination of pethidine and norpethidine in plasma. Comparison with a gas chromatographic method using electron capture detection. Biomed. Mass Spectrom. 1978, 5(9), 540-543. https://doi.org/10.1002/bms.1200050907
Hartvig P, Fagerlund C. A simplified method for the gas chromatographic determination of pethidine and norpethidine after derivatization with trichloroethyl chloroformate. J. Chromatogr. B Biomed. Appl. 1983, 274, 355-360. https://doi.org/10.1016/S0378-4347(00)84443-6
Xiaolu S, Hongwei Q, Jianmei W, Bin D, Youmei W. Determination of dezocine and pethidine in human hair by UPLC-MS/MS. J. China Pharm. Univ. 2022, 53(1), 74-78. https://doi.org/10.11665/j.issn.1000-5048.20220111
Xu F, Liu L. Simultaneous determination of free methamphetamine, pethidine, ketamine and tramadol in urine by dispersive liquid–liquid microextraction combined with GC–MS. Forensic Sci. Res. 2019, 4(2), 188-194. https://doi.org/10.1080/20961790.2017.1377386
Silvestre CI, Santos JL, Lima JL, Zagatto EA. Liquid–liquid extraction in flow analysis: A critical review. Anal. Chim. Acta. 2009, 652(1-2), 54-65. https://doi.org/10.1016/j.aca.2009.05.042
de Campos EG, da Costa BRB, Dos Santos FS, Monedeiro F, Alves MNR, Santos Junior WJR, De Martinis BS. Alternative matrices in forensic toxicology: A critical review. Forensic Toxicol. 2022, 40(1), 1-18. https://doi.org/10.1007/s11419-021-00596-5
MacPherson RD, Duguid M. Strategy to eliminate pethidine use in hospitals. J. Pharm. Pract. Res. 2008, 38(2), 88-89 8. https://doi.org/10.1002/j.2055-2335.2008.tb00807.x
İndir
Yayınlanmış
Sürüm
- 2025-04-19 (2)
- 2025-03-01 (1)
Sayı
Bölüm
Lisans
Telif Hakkı (c) 2025 Adli Tıp Bülteni

Bu çalışma Creative Commons Attribution 4.0 International License ile lisanslanmıştır.
Dergimiz ve bu internet sitesinin tüm içeriği Creative Commons Attribution (CC-BY) lisansının şartları ile ruhsatlandırılmıştır. Creative Commons Attribution Lisansı, kullanıcıların bir makaleyi kopyalamasına, dağıtmasına ve nakletmesine, makaleyi uyarlamasına ve makalenin ticari olarak kullanılmasına imkan tanımaktadır. CC BY lisansı, yazarına uygun şekilde atfedildiği sürece açık erişimli bir makalenin ticari ve ticari olmayan mahiyette kullanılmasına izin vermektedir.