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Synergism

المؤلف:  Max M. Houck، Jay A. Siegel

المصدر:  Fundamentals of Forensic Science

الجزء والصفحة:  360

2026-08-11

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Synergism

You may have heard the expression; “The whole is greater than the sum of the parts.” In pharmacology, this means that the total effects on the body of two or more drugs taken together is greater than the effects would be if the drugs are taken separately. The drugs work together to magnify their effects or create effects that would not have occurred otherwise. This is called synergism. A forensic toxicologist must be aware of synergism when making conclusions about the role of a drug in the cause and man ner of death. The toxicologist must know what drugs were taken and what drugs were already present when another one is taken and must be aware of synergistic effects. Many new drugs come onto the market every year to treat various diseases and ailments. It is not possible to test these drugs against all other drugs that a person might be taking at the same time. As a result, synergisms might occur that are unanticipated. One of the most well-known synergisms in toxicology is that of alcohol and barbiturates. Barbiturates are CNS depressants. They slow down many functions of the body and may induce drowsiness or sleep. Alcohol is also a CNS depressant, but its mechanism of action is different than barbiturates. When alcohol and barbiturates are taken together, the depressant effects are greatly magnified over what they would be if the alcohol and drugs were taken separately. The effects can be magnified to the point where a person may die even from sublethal quantities of both the alcohol and barbiturates. This combination of substances was apparently the cause of death of rock stars Janice Joplin and Jimi Hendrix, for example. There have been many reports of both accidental and deliberate cases of overdose by alcohol and barbiturates in the United States each year. Sometimes it is difficult to determine if two drugs are acting synergistically. For example, if someone takes two CNS depressant drugs and has a significant reaction, it may be that the drugs’ effects were merely additive, rather than enhanced. Syner gism is easiest to detect if someone takes two drugs and has effects that would not be expected from either one of the drugs.