Driving Under the Influence of Drugs: Looking for Reasonable Blood Cutoffs and Realistic Analytical Values

[摘要] To the Editor:Psychotropic drugs affecting the central nervous system have the potential to impair driving ability. Among the issues in assessing the impact of drugs on driving are ( a ) the appropriateness of the biological matrix in objectively measuring the presence of the drugs and/or metabolites, ( b ) the reliability of the detection method in measuring them, and ( c ) the “cutoff values” applied to drugs eventually found in relation to driving impairment (1).Regarding the first issue, the effects of drugs on driving performance should associate with drug concentration in the brain. The best indicator here is the concentration of the drug and/or metabolites in blood and to a lesser extent oral fluid. Concerning the reliability of the analytical methods, fully validated chromatography-mass spectrometry hyphenated techniques are available to consistently identify and quantify several psychoactive substances in blood. Then there is the important issue of what cutoffs should be used in the unambiguous identification of …

[学科分类] 过敏症与临床免疫学