Postmortem absorption of drugs and ethanol from aspirated vomitus — An experimental model

Pounder, Derrick J.; Yonemitsu, Kosei

doi:10.1016/0379-0738(91)90185-l

Cited by 50 publications

(16 citation statements)

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“…The results showed that postmortem contamination of the airways occurred in the present model, and that this process increased the postmortem drug concentration in most compartments. This confirms the findings of Pounder and Yonemitsu [8] on postmortem absorption of drugs and ethanol from the airways in an experimental human model. The lungs have a large surface area, thin diffusion membrane and a high vascularity that will favour diffusion of any aspirated drug.…”

Section: Discussionsupporting

confidence: 91%

Diffusion as a mechanism of postmortem drug redistribution: An experimental study in rats

Hilberg¹,

Bugge²,

Beylich³

et al. 1992

Int J Leg Med

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In some cases of drug overdose there is a reservoir of unabsorbed drug in the stomach and gut. Furthermore, agonal aspiration might establish a second reservoir in the lungs. Two experimental rat models were used to study if diffusion from these reservoirs could contribute to the phenomenon of postmortem drug redistribution. Overnight fasted rats were sacrificed by CO2 and 75 mg of amitriptyline (AMI) was administered by a gastric tube. In the first series (n = 19), the tubes were removed after AMI administration. In the second series (n = 17), the trachea was ligated and cut prior to drug administration to prevent airways contamination. The rats were left at room temperature on their back for a period of 5, 10, 24, 48, 96 up to 192 h and samples of heart blood, blood from the inferior vena cava, tissue samples from heart, lungs, different liver lobes, kidney and psoas muscle were taken. In both series of rats we observed that as early as 5 h postmortem increasing concentrations of amitriptyline were found in the liver lobes lying closest to the stomach. In rats where the trachea was not ligated, drug contamination of the lungs also resulted in an increase in drug concentration within 5 h in heart blood and heart muscle. In rats where the trachea had been ligated, amitriptyline was found in the lungs after 96 h postmortem. The main metabolite nortriptyline was also detected.(ABSTRACT TRUNCATED AT 250 WORDS)

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Section: Discussionsupporting

confidence: 91%

Diffusion as a mechanism of postmortem drug redistribution: An experimental study in rats

Hilberg¹,

Bugge²,

Beylich³

et al. 1992

Int J Leg Med

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“…Il en résulte une élévation des concentrations dans les gros vaisseaux du médiastin, aorte et veine cave supérieure, plus marquée que celle observée au niveau des cavités cardiaques droites et gauches. Ceci a été clairement mis en évidence pour l'éthanol, le paracetamol et le dextro- propoxyphene (11). Il semblerait d'autre part que ce phénomène de diffusion puisse intéresser également l'oesophage et l'intestin grêle (5).…”

Section: ^Redistribution Depuis Le Tractus Digestifunclassified

“…En post-mortem, la redistribution de ces molécules depuis les sites d'accumulation intra-pulmonaires vers la circulation pulmonaire est rapide et intense, et débute vraisemblablement dès la deuxième heure après le décès (16). Ce phénomène de diffusion entraîne une augmentation des concentrations dans les cavités cardiaques et les vaisseaux thoraciques (Figure 2), avec pour corollaire une diminution de concentration de ces molécules dans le parenchyme pulmonaire (4,6,11). De nombreux cas d'augmentation des concentrations dans le sang des veines et artères pulmonaires ont ainsi été décrits dans la littéra-ture, et font toujours mention d'une élévation des concentrations dans l'aorte et les cavités cardiaques gauches supérieure à celle des concentrations dans la veine cave supérieure et les cavités droites.…”

Section: >^ Redistribution à Partir Des Poumonsunclassified

“…Il serait possible d'observer une diffusion directe, de contiguïté, depuis le parenchyme ou les capillaires pulmonaires entourant les bronches gauches et la carina vers l'aorte et les cavités cardiaques gauches, puis plus tardivement vers la veine cave supé-rieure et les cavités droites (20). En effet, les concentrations aortiques sont supérieures à celles des cavités gauches, et la concentration dans la veine cave supé-rieure est supérieure à celle des cavités droites, laissant supposer que la diffusion vers ces vaisseaux se fait éga-lement directement par les tissus adjacents, et non pas uniquement par l'intermédiaire des vaisseaux pulmonaires (11). Selon Fuke et al (6), ces phénomènes de diffusion à partir du tissu pulmonaire seraient plus intenses que ceux observés à partir de l'estomac.…”

Section: >^ Redistribution à Partir Des Poumonsunclassified

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Mécanismes de la redistribution post-mortem des xénobiotiques : le point sur l'état actuel des connaissances

et al. 2001

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“…The redistribution mechanisms of xenobiotics from reservoir organs (stomach, lungs, liver, cardiac muscle) have been extensively described [2][3][4][5][6][7]. Similarly, variations in concentrations related to cell lysis and putrefaction have been the object of several studies [8,9].…”

Section: Introductionmentioning

confidence: 99%

Post-mortem redistribution of three beta-blockers in the rabbit

et al. 2005

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To consider the role of the physico-chemical properties of drugs in their post-mortem redistribution, we designed the present study to investigate the influence of lipophilicity using an experimental rabbit model. Three beta-blockers (BB), atenolol, metoprolol and propranolol, with a similar dissociation constant (pK (a)) and increasing partition coefficient (K (p)) were administered intravenously to 18 rabbits. One hour after the last administration, the animals were killed by thiopental injection and placed in a supine position at room temperature. Autopsies were performed at 0, 2, 6, 12, 24 and 48 h post-mortem. Concentrations of the three BB were determined in fluids (right and left cardiac blood, peripheral blood, urine, bile, stomach content, vitreous humour) and tissues (cardiac muscle, lungs, liver, brain, diaphragm, iliopsoas muscle) using a previously published, validated liquid chromatography-electrospray-mass spectrometry method. Our results show that lipophilicity influences post-mortem redistribution of the molecules in a certain number of anatomical sites such as the stomach, lungs, cardiac muscle, cardiac blood or liver, but does not appear to intervene in other sites such as the brain or the vitreous humour.

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Postmortem absorption of drugs and ethanol from aspirated vomitus — An experimental model

Cited by 50 publications

References 5 publications

Diffusion as a mechanism of postmortem drug redistribution: An experimental study in rats

Diffusion as a mechanism of postmortem drug redistribution: An experimental study in rats

Mécanismes de la redistribution post-mortem des xénobiotiques : le point sur l'état actuel des connaissances

Post-mortem redistribution of three beta-blockers in the rabbit

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