Analytical data supporting the “theoretical” postmortem redistribution factor (F_t): a new model to evaluate postmortem redistribution

Figures & data

Table 1. Liver/peripheral blood (L/P) ratio data, and theoretical postmortem redistribution factor (F_t): alphabetical listing for 44 drugs.

Drug	n	L/P (median)	Ft
Acetaminophen	15	1.1	1.0
Amiodarone	5	41.9	3.6
Amitriptyline	57	16.4	2.3
Amlodipine	9	27.8	2.9
Amphetamine	15	7.0	1.6
Bupropion	11	1.0	1.0
Carisoprodol	11	2.0	1.1
Chlorpheniramine	3	9.5	1.8
Citalopram	37	7.5	1.7
Clomipramine	5	61.0	4.3
Clozapine	12	6.7	1.6
Cyclobenzaprine	13	19.6	2.5
Desipramine	6	44.6	3.7
Dextromethorphan	4	8.6	1.8
Diltiazem	8	17.2	2.4
Diphenhydramine	54	6.7	1.6
Doxepin	20	19.4	2.5
Doxylamine	3	2.9	1.2
Fentanyl	16	5.9	1.5
Fluoxetine	48	30.0	3.1
Gabapentin	28	0.65	0.97
Guaifenesin	5	0.9	1.0
Hydrocodone	38	3.0	1.2
Hydroxyzine	10	12.3	2.0
Imipramine	6	28.8	3.0
Lamotrigine	3	8.5	1.8
Meprobamate	8	0.9	1.0
Methadone	94	4.8	1.4
Methamphetamine	18	6.2	1.6
Metoprolol	6	3.5	1.3
Mirtazapine	5	12.0	2.0
Naproxen	20	1.0	1.0
Olanzapine	20	12.0	2.0
Paroxetine	19	29.2	3.0
Promethazine	9	9.1	1.8
Propoxyphene	35	9.0	1.8
Propranolol	6	10.9	1.9
Quetiapine	65	11.2	2.0
Sertraline	9	76.0	4.8
Tramadol	36	2.3	1.1
Trazodone	19	2.8	1.2
Venlafaxine	42	3.3	1.3
Zolpidem	14	2.4	1.2
Ethanol			1.0

Table 2. Case examples: postmortem redistribution factor (F) compared to theoretical postmortem redistribution factor (F_t).

Drug	P/AM	F	Ft	T1	T2
Ethanol	0.28/0.27	1.0	1.0	36	42
	0.059/0.057	1.0	1.0	4	11
Gabapentin	20/20	1.0	0.97	4	11
Fentanyl	0.0016/0.0014	1.1	1.5	11	13
Zolpidem	0.030/0.027	1.1	1.2	17	18
Methadone	0.56/0.39	1.4	1.4	18	6.7
Amphetamine	0.07/0.05	1.4	1.6	7	22
	0.16/0.10	1.6	1.6	9	5.2
Methamphetamine	0.44/0.33	1.3	1.6	7	22
	13.0/9.3	1.4	1.6	7	5.2
	0.34/0.19	1.7	1.6	8	30
Metoprolol	7.0/6.2	1.1	1.3	1	26
Quetiapine	0.24/0.15	1.6	2.0	4	11

P, postmortem peripheral blood concentration (mg/L; ethanol g/dL); AM, antemortem blood concentration (mg/L; ethanol g/dL); F, postmortem redistribution factor (actual); F_t, theoretical postmortem factor (using Equation (2(2) )); T1, time between antemortem specimen collection and death (minutes); T2, postmortem delay (hours).

Figure 1. Case examples: postmortem redistribution factor (F) compared to theoretical postmortem redistribution factor (F_t).

Table 3. Theoretical postmortem redistribution factor (F_t): listed in increasing propensity for postmortem redistribution (PMR).

Drug	Ft
Gabapentin	0.97
Ethanol	1.0
Naproxen	1.0
Guaifenesin	1.0
Acetaminophen	1.0
Bupropion	1.0
Meprobamate	1.0
Carisoprodol	1.1
Tramadol	1.1
Hydrocodone	1.2
Trazodone	1.2
Doxylamine	1.2
Zolpidem	1.2
Metoprolol	1.3
Venlafaxine	1.3
Methadone	1.4
Fentanyl	1.5
Amphetamine	1.6
Clozapine	1.6
Diphenhydramine	1.6
Methamphetamine	1.6
Citalopram	1.7
Chlorpheniramine	1.8
Dextromethorphan	1.8
Lamotrigine	1.8
Promethazine	1.8
Propoxyphene	1.8
Propranolol	1.9
Hydroxyzine	2.0
Mirtazapine	2.0
Olanzapine	2.0
Quetiapine	2.0
Amitriptyline	2.3
Diltiazem	2.4
Cyclobenzaprine	2.5
Doxepin	2.5
Amlodipine	2.9
Imipramine	3.0
Paroxetine	3.0
Fluoxetine	3.1
Amiodarone	3.6
Desipramine	3.7
Clomipramine	4.3
Sertraline	4.8