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- Title
Postmortem Drug Redistribution: A Compilation of Postmortem/Antemortem Drug Concentration Ratios.
- Authors
Mantinieks, Dylan; Gerostamoulos, Dimitri; Glowacki, Linda; Rago, Matthew Di; Schumann, Jennifer; Woodford, Noel W; Drummer, Olaf H
- Abstract
Postmortem drug redistribution (PMR) is a well-known phenomenon in forensic toxicology with implications for medico-legal death investigations. Paired antemortem (AM) specimen and postmortem (PM) mortuary admission femoral blood drug concentrations from 811 coronial cases were used to construct a retrospective compilation of PM/AM drug concentration ratios for 42 parent drugs and metabolites. The median PM/AM ratios for all antidepressants were > 1 and consistent with PMR In contrast, the median PM/AM ratios of most benzodiazepines were < 1. The antipsychotics were varied (0.63–3.3) and suggest the mixed effects of PMR and drug instability. Amphetamines exhibited no trends (0.90–0.95) and are likely confounded by many factors. The PM/AM ratios of cardiovascular drugs, opioids and other drugs are also reported. This research represents an expansive retrospective compilation of paired AM and PM drug concentrations for many toxicologically relevant drugs. While the median PM/AM ratios demonstrate some drug-dependent trends, there was no obvious relationship between AM specimens and PM femoral blood taken at mortuary admission.
- Subjects
AUTOPSY; CARDIOVASCULAR agents; FORENSIC toxicology; OPIOIDS; DRUGS; ANTIDEPRESSANTS; PHARMACODYNAMICS; ARIPIPRAZOLE
- Publication
Journal of Analytical Toxicology, 2021, Vol 45, Issue 4, p368
- ISSN
0146-4760
- Publication type
Academic Journal
- DOI
10.1093/jat/bkaa107