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Postmortem changes in blood amitriptyline concentration

D J Pounder1, V Owen, C Quigley

  • 1Department of Forensic Medicine, University of Dundee, Scotland.

The American Journal of Forensic Medicine and Pathology
|September 1, 1994
PubMed
Summary
This summary is machine-generated.

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Postmortem toxicology reveals complex drug diffusion from reservoirs like lungs and gastric contents into blood and fluids. Amitriptyline and salicylate concentrations varied significantly over time and in different tissues.

Area of Science:

  • Forensic Toxicology
  • Postmortem Medicine

Background:

  • Investigating postmortem drug distribution is crucial for accurate toxicological interpretation.
  • Understanding drug diffusion dynamics aids in determining time of overdose and estimating concentrations.

Observation:

  • Two suicide cases involving amitriptyline overdose, one with co-ingested salicylate, were analyzed.
  • Drug concentrations in blood, tissues, and fluids were measured at various postmortem intervals.
  • Significant drug residue was found in gastric and intestinal contents, and lung tissue.

Findings:

  • Amitriptyline and salicylate concentrations in blood showed variability over time post-discovery.
  • Pulmonary vein amitriptyline levels increased faster than pulmonary artery levels, suggesting lung diffusion.

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  • Liver exhibited the highest concentrations for both amitriptyline and salicylate.
  • Pleural fluid amitriptyline levels were higher on the left, indicating gastric origin diffusion.

    • Implications:

    • Postmortem drug diffusion from reservoirs complicates interpretation of toxicological findings.
    • Accurate assessment requires considering drug redistribution from solid organs and gastrointestinal tract.
    • These findings highlight the importance of comprehensive tissue and fluid analysis in forensic toxicology.