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Extra resources for Drug Testing in Alternate Biological Specimens (Forensic Science and Medicine)
A PCP concentration of 3 μg/L was detected almost 6 weeks after drug use (15). Specimens of Maternal Origin: Amniotic Fluid and Breast Milk 13 Therapeutic use of narcotic analgesics during the delivery and postpartum phase is not uncommon. Although transfer of morphine to the infant through the milk was once considered negligible, low oral doses of morphine to nursing mothers produced drug concentrations in milk up to 100 μg/L and were extremely variable between feeds (22). The morphine concentration in the infant serum was 4 μg/L, which was considered to be in the analgesic range.
2002;72(2):184–91. 36. Spigset O, Carieborg L, Ohman R, Norstrom A. Excretion of citalopram in breast milk. Br J Clin Pharmacol. 1997;44(3):295–8. 37. Steiner E, Villen T, Hallberg M, Rane A. Amphetamine secretion in breast milk. Eur J Clin Pharmacol. 1984;27(1):123–4. 38. Winecker RE, Goldberger BA, Tebbett IR, Behnke M, Eyler FD, Karlix JL, Wobie K, Conlon M, Phillips D, Bertholf RL. Detection of cocaine and its metabolites in breast milk. J Forensic Sci. 2001;46(5):1221–3. 39. Chasnoff IJ, Lewis DE, Squires L.
The kinetics of drug transfer have been reviewed (24), and it has been suggested that drugs reach the fetus by various complex pathways: • Passive diffusion of small molecule lipid-soluble drugs across the placental barrier, which may be further metabolized by the fetus depending on gestational age • Binding of drugs and/or metabolites to proteins in the amniotic fluid, which is then swallowed by the fetus. Sustained swallowing of amniotic fluid may prolong fetal exposure to drugs (25). Therefore, drugs enter the fetal circulation through various pathways that depend upon many parameters.