A woman (weighing 180 lb) was found dead in her bed with an empty bottle of morp

Question

A woman (weighing 180 lb) was found dead in her bed with an empty bottle of morphine (80 mg tablets) beside her. The label on the bottle said to take two pills a day, one in the morning and one at night. Her gastric contents contained 1020 mg/L codeine (650 mL total volume) and her blood contained 10.5 mg/L morphine. (The GC/MS analysis also showed 0.010 mg/L morphine, a metabolite of morphine.) If the volume of distribution (Vd) of morphine is 5.5 L/kg, what is the minimum number (ignoring the morphine) of tablets that the victim had ingested? Is this number consistent with an intentional drug overdose (suicide)? (Hint: dose amount = Vd ´mass ´ concentration)

Explanation / Answer

The mass of drug found in the gastric fluid was:

mass = (concentration)(volume) = (1020 mg/L) (0.650 L) = 663 mg

The mass of drug found in the blood was:

mass = (Vd)(mass)(concentration) = (5.5 L/kg)(180 lb)(0.650 kg/lb)(10.5mg/L) = 6756.75mg

Thus, the total mass of drug ingested was

663 + 6756.75 mg = 7419.75mg

and the number of tablets must have been:

Gastric contents: 663 mg /(60 mg/tablet) = 11.05 =11tablet
Total contents :    6756.75mg /(60 mg/tablet) = 112.61=112 tablets

The large number of tablets in the gastric fluid and the large total number are both consistent with a suicide.

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