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The renewed table, 2004.
June till September 2004 the Dutch pharmacist student Marieke Welzen, M.Sc. in pharmacology and chemistry under supervision of Professor Dr. Donald R.A. Uges, hospital pharmacist and clinical and forensic toxicologist - pharmacologist renewed and updated the TIAFT reference blood concentration list totally. Now we provide you with the newest compilation of blood or plasma levels of more than 800 substances and active metabolites.
Molecular weights have been added for the colleagues using moles in stead of mg per litre.
For this new list the following existing lists and sources have been sought and were critically compared.
1. D.R.A. Uges: The old TIAFT list was based on the list of Donald R.A. Uges, Ph.D. In 1982 he published his first list of drug data in the Netherlands. Later on compilations of new drug data were published in 1987 and 1995. All these drug data have been obtained from surveys of colleagues and medical specialists, from information from literature and pharmaceutical industries and by comparison with several well known drug data list.
2. M. Schulz and A. Schmoldt, Therapeutic and toxic concentrations of more than 800 drugs and other xenobiotics. Pharmazie 2003; 58: 447-474
3. Ch.Winek. Annual Drug and Chemical Blood Level Data PC Laboratory 1320 5th Ave. Pittsburgh PA, USA, 2004
4. Moffat AC, Osselton MD, Widdop B; Clarke’s Analysis of Drug and Poisons in pharmaceuticals, body fluids and post-mortem material. Third Ed. London, Pharmaceutical Press, 2004;.
5. R.C. Baselt. Disposition of Toxic Drugs and Chemicals in Man., Sixth Ed. Foster City CA. Biomedical Publ., 2002.
6. Micromedex ® (Healthcare Series, CD-Rom), 2004
7. C. Dollery. Therapeutic Drugs. Second Ed. Edinburgh. Churchill Livingstone.1999 Ideally these reference drug data are from patients under the same condition and with the same age, illness and medication as the patients involved in your case. Unfortunately there are great intra- and interindividual differences between individuals.These differences are even greater between patients and healthy volunteers. Nevertheless, for those who know the relevant pharmacokinetic  and pharmacodynamic factors (and pitfalls) that can influence the serum concentrations of drugs, a list of reliable therapeutic and toxic reference values can be very valuable. However, the forensic toxicologists has to be aware that these so called therapeutic and toxic drug concentrations are clinical data in serum or plasma and not in post-mortem whole blood.
Therapeutic levels are the steady state concentrations that need to be reached for the drug to exert a significant clinical benefit without causing unacceptable side effects.
Toxic levels are serum concentrations above which unacceptable, concentration dependent, side- or toxic effects might appear.
It has to be taken in account, that these values will never be static and might change with advancing knowledge or with other (therapeutic) use of the compounds. Nor the members of the TIAFT reference committee, nor the Board of TIAFT, nor the TIAFT organisation is responsible for any consequence by any error in this list. Using these data is for your own liability!
Use of drug data without sufficient knowledge about the patient or victim, the case and about pharmacokinetics, toxicokinetics and pharmacodynamics might give a wrong interpretation.
The Members of the TIAFT reference committee are: Donald Uges Ph.D., Groningen, Netherlands, Anni Steentoft Ph.D., Copenhagen, Denmark and Charles Winek Ph.D. , Pittsburgh PA, USA are convinced that this compilation gives the most reliable comprehensive drug data information for clinical and forensic toxicologists at this moment.
It is very important that every TIAFT member who has reliable new reference data, or has noticed errors in this list or got new insights or experiences will send this information (with scientific foundations) to Donald R.A. Uges Ph.D. d.r.a.uges@apoth.azg.nl. tel. 00.31.50.361.4071
Laboratory for Clinical and Forensic Toxicology and Drug Analysis
University Hospital Groningen P.O. Box 30.001, 9700 RB Groningen The Netherlands.

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