Epidemiology and Adverse Drug Reactions

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In forensics, a common situation causing an adverse drug reaction (ADR) or more general toxic reaction is the use of illicit drugs. Side effects are usually unwanted but more often are associated with the pharmacological actions of the drugs and may result from an incorrect dose. Reviewing exposures and adverse outcomes across a larger number of cases provides a much better opportunity to understand the incidence of any particular adverse outcome in a whole range of situations. This review of multiple cases provides an epidemiological approach to forensic medicine. There are many good examples found in the literature. A review of 332 fatal poisonings involving amitriptyline, propoxyphene and promazine showed that the median blood concentrations were substantially lower in alcohol-related cases than in drug-only poisonings. Combinations of drugs are clearly much more diverse than simply comparing cases with and without alcohol.

Original languageEnglish
Title of host publicationHandbook of Forensic Medicine
EditorsBurkhard Madea
Place of PublicationWest Sussex UK
Number of pages5
ISBN (Electronic)9781118570654
ISBN (Print)9780470979990
Publication statusPublished - 5 May 2014


  • Adverse drug reaction (ADR)
  • Alcohol-related cases
  • Drug-drug combinations
  • Drug-only poisonings
  • Epidemiological approach
  • Toxicity

Cite this

Drummer, O. H., Gerostamoulos, D., & Pilgrim, J. L. (2014). Epidemiology and Adverse Drug Reactions. In B. Madea (Ed.), Handbook of Forensic Medicine (pp. 840-844). Wiley-Blackwell. https://doi.org/10.1002/9781118570654.ch46