Important Notice: Our web hosting provider recently started charging us for additional visits, which was unexpected. In response, we're seeking donations. Depending on the situation, we may explore different monetization options for our Community and Expert Contributors. It's crucial to provide more returns for their expertise and offer more Expert Validated Answers or AI Validated Answers. Learn more about our hosting issue here.

Why were the postmortem levels of amitriptyline so high in this patient?

0
Posted

Why were the postmortem levels of amitriptyline so high in this patient?

0

Such levels indicate an overdose–the question is whether it was an acute, intentional overdose on the part of the patient or a chronic, unintentional overdose. Before discussing this differential diagnosis, a note of caution must be given about interpreting postmortem levels of drugs such as amitriptyline, which have a large volume of distribution and are highly protein bound. As illustrated in the case titled “What Happened to Tommy?”4 , postmortem levels of such drugs are increased relative to antemortem levels. In that case, a plasma level was obtained within 30 minutes before death and then a postmortem blood level was obtained several hours after death. The postmortem level was approximately 5 times higher than the antemortem level. Why? Recall that the postmortem sample in the case of the 35-year old man described here (and in most such cases) was whole blood, which was to some degree autolysized. In contrast, antemortem levels are based on plasma, which is prepared by spinning

Thanksgiving questions

*Sadly, we had to bring back ads too. Hopefully more targeted.