CTEH^®’s pharmacology services are under the direction of Susan Shelnutt, Ph.D. Dr. Shelnutt is a pharmacologist, toxicologist, and licensed pharmacist with 29 years of experience. She has conducted pharmacokinetic analyses of drugs and chemicals, and comprehensive evaluations of the effects and adverse effects of drugs and chemicals. Dr. Shelnutt has extensive experience assessing the human toxicity of drugs and chemicals, and drug interactions and adverse reactions. She has additional experience in pharmacokinetic analysis. Dr. Shelnutt also serves as an Adjunct Assistant Professor in the Department of Environmental and Occupational Health, College of Public Health at the University of Arkansas for Medical Sciences.

Levels of drugs or chemicals in blood and/or urine are frequently key pieces of information in accidents, worker exposure issues, and in exposures to environmental chemicals. Proper evaluation and interpretation of these levels is essential. Multiple drugs or chemicals (including alcohol) are commonly found in blood samples taken from individuals, particularly after involvement in an accident. These compounds often have additive and supra-additive (synergistic) effects on the body. To evaluate these and other complex pharmacological situations, we use scientifically sound pharmacokinetic modeling of compounds at earlier points in time (at, for example, the time of an accident). We then conduct a pharmacological evaluation, using peer-reviewed medically accepted information sources, to provide an assessment of the compounds’ effects on the individual over time.

As part of our evaluation, we review the individual’s medical records so that pharmacokinetic analyses and pharmacological assessments can be made that are specific for the individual. We consider any medical problems, such as altered liver or kidney function, that might result in unusually high or low blood levels, or that might render the individual more sensitive or less sensitive to the drugs or chemicals. We also use this information to determine the correct dose of medication and any drug disease state interactions or contraindications.

Specific Pharmacological Services

• Interpretation of drug and alcohol levels in body fluids
• Pharmacokinetic analysis
• Assessments of drug-drug interactions and drug-food interactions
• Optimum drug dosages
• Adverse drug reactions
• Drug Toxicity
• Proper treatment and monitoring of adverse effects on drugs
• Drug herbal supplement interactions
• Drug/disease state interactions