Sample Medical Science Essay Paper on Postmortem Changes in Blood Amitriptyline Concentration

Paper summary

The article encompasses comprehensive toxicological studies done on two suicides perpetuated by amitriptyline overdose and one with salicylate. Ten initial blood samples were taken twenty one hours after the discovery of the body and approximately twenty eight hours since the overdose. The blood samples had concentrations of 2.5- 12 mg/L for amitriptyline, 0.7-3.1mg/L for nortriptyline and 81-244 mg/L for salicylate. The samples taken 42 hours later showed corresponding concentrations of 1-39mg/L amitriptyline, 0.6-7.0mg/L for nortriptyline and 86- 310 Salicylate. It was noted that sample hemoglobin concentrations did not correlate with the drug concentrations. In addition, increase in pulmonary vein amitriptyline was more than in pulmonary artery which was due to the likelihood of more diffusion across the veins walls from the lungs. In the several tissues that were studied, drug concentrations were highest in the liver. It was also found out that there were considerable drug residues in the gastric contents and the duodenal contents. In both suicide cases, there were more concentrations of putrefactive pleural fluids on the left than on the right part of the body, possibly due to diffusion from gastric drug residue (Pounder, Owen & Quigley, American Journal of Forensic Med 15(3): 224-230, 1994).

Word Count 198

Drug note – Death case: Amitriptyline/Nortriptyline

In the two suicide cases, toxicity of Amitriptyline (1.5 mg/L) and Nortriptyline (0.9 mg/L) were the cause of death. Amitriptyline and Nortriptyline which is a metabolite of amitriptyline is rapidly absorbed following an oral administration and takes less than 2 hours to peak. Effects of overdose encompass anticholinergic effects such as coma and tachycardia, sodium channel blockade and negative inotrope which leads to slowing down of gut motility, life-threatening cardiovascular events and death within a few hours of ingestion (Pounder, Owen & Quigley, American Journal of Forensic Med 15(3): 224-230, 1994).

Word Count 99


Derrick J. Pounder, Victoria Owen and Christine Quigley (1994). Postmortem changes in blood amitriptyline concentration.  The American Journal of Forensic Medicine and Pathology 15(3): 224-230