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Related Concept Videos

Factors Affecting Drug Distribution: Organ Perfusion Rate01:15

Factors Affecting Drug Distribution: Organ Perfusion Rate

172
Drug distribution within the body is a complex process influenced by several factors, including perfusion rate, the rate at which the bloodstream transports drugs to tissue. This limitation becomes particularly significant when dealing with highly lipophilic drugs. In such cases, the rate at which the drug can move across membranes is crucial, and if the membrane is highly permeable to the drug, distribution becomes rate-limited by perfusion.
Perfusion rate-limited distribution relies on the...
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Drug Distribution: Tissue Binding01:21

Drug Distribution: Tissue Binding

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Upon entering the systemic circulation, drugs can distribute into the interstitial and intracellular fluid of various tissue cells. This distribution is facilitated by the binding of drugs to different cellular components within tissues, which may lead to drug accumulation in specific areas. Drugs bound to tissue components serve as reservoirs that release free drugs back into the system, prolonging the drug's overall action. However, this accumulation can also result in local toxicity.
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Tissue-Drug Binding: Localization of Drugs and its Significance01:24

Tissue-Drug Binding: Localization of Drugs and its Significance

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Body tissues, comprising approximately 40% of the body weight, are crucial in drug distribution and localization. These tissues can serve as drug storage sites, competing with plasma binding sites for drug molecules.
Drugs can bind to different tissue components, enhancing their distribution and localization. The factors influencing drug localization in tissues include the drug's lipophilicity, structural characteristics, tissue perfusion rate, and pH differences. These factors determine...
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Postmortem Mitragynine Distribution in a Single Drug Fatality Case.

Dani C Mata, Helen H Chang

    Academic Forensic Pathology
    |April 24, 2023
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    Summary
    This summary is machine-generated.

    This case study reports the first documented death solely from mitragynine intoxication. The investigation highlights the importance of toxicology in understanding kratom-related fatalities, even without other substances present.

    Keywords:
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    Area of Science:

    • Forensic Toxicology
    • Clinical Pathology
    • Pharmacology

    Background:

    • Substance-use disorder and past suicide attempts were noted in the decedent.
    • The decedent was reportedly abstinent from substance use for one year prior to death.
    • Autopsy revealed cardiomegaly, hepatomegaly, pulmonary congestion, cerebral edema, and obesity.

    Purpose of the Study:

    • To document a case of fatal mitragynine intoxication as the sole detected substance.
    • To provide comprehensive toxicological data for forensic investigations.
    • To enhance understanding of mitragynine's role in overdose deaths.

    Main Methods:

    • Autopsy and histopathological examination.
    • Liquid chromatography tandem mass spectrometry (LC-MS/MS) for comprehensive toxicology screening of blood and tissues.
    • Qualitative identification of 7-hydroxymitragynine in central blood.

    Main Results:

    • Mitragynine was the only controlled substance detected in central blood, peripheral blood, liver, and gastric contents.
    • Mitragynine concentrations were 7.5 mg/L (central blood), 3.3 mg/L (peripheral blood), 42.2 mg/kg (liver), and 33.1 mg (gastric contents).
    • The cause of death was determined to be acute mitragynine intoxication, with significant contributing factors including cardiomegaly, hepatomegaly, and obesity.

    Conclusions:

    • This case represents the first reported fatality where mitragynine was the sole detected drug.
    • The findings underscore the potential lethality of mitragynine and the necessity of thorough toxicological analysis in overdose investigations.
    • This study offers critical data for medical examiners and pathologists investigating deaths potentially linked to kratom (Mitragyna speciosa) use.