MDMA and MDA Concentrations in Antemortem and Postmortem Specimens in Fatalities Following Hospital Admission

Elliott, Simon

doi:10.1093/jat/29.5.296

Cited by 46 publications

(16 citation statements)

References 17 publications

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“…Patel et al found heart samples are likely to be higher than peripheral blood samples [40]. In one of the cases reported by Elliot the heart blood had a concentration of 28.39 mg/l, with a right femoral blood sample of 6.19 mg/l, left femoral blood of 7.25 mg/l and vitreous of 11.93 mg/l [43]. The post-mortem samples were taken 2 days after death.…”

Section: Discussionmentioning

confidence: 99%

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“Ecstasy” associated deaths: what is a fatal concentration ? Analysis of a case series

Milroy

2011

Forensic Sci Med Pathol

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Amphetamine derivative drugs, particularly 3,4-methylenedioxymethamphetamine (MDMA), commonly known as ecstasy, are popular recreational drugs. MDMA is associated with causing death by a number of mechanisms, including hyperpyrexia, cardiac arrhythmia water intoxication and liver failure. Seventy-seven deaths where MDMA was detected in body fluids/organs were reviewed. Of these cases 59 deaths had MDMA present in blood. In 13 cases death was attributable to the toxic effects of MDMA alone with a range of 0.478-53.9 mg/l, mean 8.43 mg/l, median 3.49 mg/l. In 22 cases death was due to polydrug use, with an MDMA range of 0.04-41.5 mg/l, mean 2.90 mg/l, median 0.76 mg/l. In 24 cases death was due to trauma with an MDMA range of 0.035-4.81 mg/l, mean 0.862 mg/l, median 0. 483 mg/l. There is considerable overlap between the concentration of MDMA seen in deaths from direct MDMA toxicity and deaths associated with trauma. These findings show, that like other stimulant drugs, no specific concentration can be used to determine death without consideration of the history and full autopsy findings.

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Section: Discussionmentioning

confidence: 99%

“…Examination of 5 cases where both ante-mortem and post-mortem samples were available revealed ante-mortem concentraions of MDMA of 0.55-4.33 mg/l with post-mortem values of 0.47 and 28.39 mg/l. [43]. The second problem is that MDMA is subject to post-mortem redistribution, due to its high volume of distribution [44].…”

Section: Discussionmentioning

confidence: 99%

“Ecstasy” associated deaths: what is a fatal concentration ? Analysis of a case series

Milroy

2011

Forensic Sci Med Pathol

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“…that relatively small increases in doses result in disproportional increases in MDMA blood concentrations [19]. Furthermore, femoral blood is generally accepted as the most reliable blood sample for drug analysis in fatalities [20]; however, Elliot [21] has shown that MDMA and MDA exhibit post-mortem redistribution and that the femoral blood concentrations of MDMA and MDA are higher than antemortem findings close to death.…”

Section: Discussionmentioning

confidence: 99%

Post-mortem cases involving amphetamine-based drugs in the Netherlands

Verschraagen¹,

Maes²,

Ruiter³

et al. 2007

Forensic Science International

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“…Thus, an elevated central blood level may somehow reflect the drug concentration in the heart. The central to peripheral blood concentration ratios have been investigated for various compounds [135][136][137][138] and their values are listed in the table in supplementary material. As drugs diffuse not only from the myocardium but also from other surrounding organs, these data in some cases may be misleading.…”

Section: Introductionmentioning

confidence: 99%

Plasma vs heart tissue concentration in humans – literature data analysis of drugs distribution

Tylutki

Polak

2015

Biopharm & Drug Disp

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ABSTRACT:Little is known about the uptake of drugs into the human heart, although it is of great importance nowadays, when science desires to predict tissue level behavior rather than to measure it. Although the drug concentration in cardiac tissue seems a better predictor for physiological and electrophysiological changes than its level in plasma, knowledge of this value is very limited. Tissue to plasma partition coefficients (Kp) come to rescue since they characterize the distribution of a drug among tissues as being one of the input parameters in physiologically based pharmacokinetic (PBPK) models. The article reviews cardiac surgery and forensic medical studies to provide a reference for drug concentrations in human cardiac tissue. Firstly, the focus is on whether a drug penetrates into heart tissue at a therapeutic level; the provided values refer to antibiotics, antifungals and anticancer drugs. Drugs that directly affect cardiomyocyte electrophysiology are another group of interest. Measured levels of amiodarone, digoxin, perhexiline and verapamil in different sites in human cardiac tissue where the compounds might meet ion channels, gives an insight into how these more lipophilic drugs penetrate the heart. Much data are derived from postmortem studies and they provide insight to the cardiac distribution of more than 200 drugs. The analysis depicts potential problems in defining the active concentration location, what may indirectly suggest multiple mechanisms involved in the drug distribution within the heart.

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MDMA and MDA Concentrations in Antemortem and Postmortem Specimens in Fatalities Following Hospital Admission

Cited by 46 publications

References 17 publications

“Ecstasy” associated deaths: what is a fatal concentration ? Analysis of a case series

“Ecstasy” associated deaths: what is a fatal concentration ? Analysis of a case series

Post-mortem cases involving amphetamine-based drugs in the Netherlands

Plasma vs heart tissue concentration in humans – literature data analysis of drugs distribution

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