ADVANCING TOWARDS MULTIDISCIPLINARY INTEGRATION: PHARMACOGENETICS' ROLE IN FORENSIC TOXICOLOGY

Pharmacogenetics investigates how DNA genes respond individually to drug administration. With advancements in genome sequencing and molecular genetics, pharmacogenetic research has gained traction, offering insights beyond medical applications. It emerges as a valuable tool in deciphering toxicological data in post-mortem examinations, pivotal for determining causes and circumstances of death. This systematic literature review aims to sensitize the forensic community to the potential of pharmacogenetics and provide a procedural guide for forensic toxicologists dealing with drug-related fatalities of uncertain origins. The review encompassed searches with keywords like 'pharmacogenetics' and 'forensic toxicology', yielding 125 articles, with 29 meeting inclusion criteria. The majority (75%) were original articles (n = 21), while 25% were case reports (n = 7). Among the studies, 78% (n = 22) involved deceased individuals subjected to complete autopsies, with the remaining 22% (n = 6) focusing on healthy subjects administered drugs for subsequent pharmacogenetic analysis. Opioids (codeine, morphine, methadone) were the most studied drugs, followed by antidepressants (tricyclic antidepressants, venlafaxine). Across the studies, there was consistent emphasis on the indispensability of pharmacogenetic assessments in drug-related deaths, particularly in cases not involving drug overdose. This review underscores the significance of forensic pharmacogenetics, a field within toxicology that remains incompletely understood yet proves invaluable in sudden deaths, overdoses, drug administration-related fatalities, and cases of alleged medical negligence.