Jones G R, Pounder D J
Office of the Chief Medical Examiner, Edmonton, Alberta, Canada.
J Anal Toxicol. 1987 Sep-Oct;11(5):186-90. doi: 10.1093/jat/11.5.186.
A 25-year-old female died from a suicidal overdose of imipramine, acetaminophen, codeine, diphenhydramine, and ethanol. Blood samples from ten segregated arterial and venous sites, twenty-four tissue samples, cerebrospinal fluid, vitreous humor, and bile were analyzed. Imipramine and desipramine, which were highly concentrated in the liver and lungs, each showed marked site dependent differences in blood concentrations. The highest concentrations were in pulmonary venous blood and the lowest in peripheral venous blood. Imipramine concentrations in the ten blood samples differed by as much as 760% (range 2.1 to 16.0 mg/L). Blood desipramine concentrations ranged from 1.4 to 10.6 mg/L. In contrast, blood concentrations of acetaminophen differed by less than 20% (55 to 65 mg/L) and blood ethanol concentrations ranged from 151 to 175 mg/100 mL. Blood concentrations of diphenhydramine ranged from 0.34 to 2.07 mg/L and codeine from 0.33 to 0.89 mg/L. The data illustrates that a marked site dependent variability in postmortem blood concentrations exists for some drugs but not others.
一名25岁女性因过量服用丙咪嗪、对乙酰氨基酚、可待因、苯海拉明和乙醇自杀身亡。对来自十个不同动脉和静脉部位的血样、二十四个组织样本、脑脊液、玻璃体液和胆汁进行了分析。丙咪嗪和去甲丙咪嗪在肝脏和肺中高度浓缩，在血药浓度上均表现出明显的部位依赖性差异。最高浓度出现在肺静脉血中，最低浓度出现在外周静脉血中。十个血样中的丙咪嗪浓度差异高达760%（范围为2.1至16.0毫克/升）。血中去甲丙咪嗪浓度范围为1.4至10.6毫克/升。相比之下，对乙酰氨基酚的血药浓度差异小于20%（55至65毫克/升），血中乙醇浓度范围为151至175毫克/100毫升。血中苯海拉明浓度范围为0.34至2.07毫克/升，可待因浓度范围为0.33至0.89毫克/升。数据表明，某些药物在死后血药浓度中存在明显的部位依赖性变异性，而其他药物则不存在。
