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Postmortem redistribution

المؤلف:  Sue Jickells , Adam Negrusz (Editors)

المصدر:  Clarkes Analytical Forensic Toxicology

الجزء والصفحة:  36

2026-09-15

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Postmortem redistribution

The unequal distribution of drugs in tissues leads to changes in the blood concentration of drugs after death. This is called postmortem redistribution and occurs primarily by diffusion of drug from neighbouring tissue sites and from organs, such as from stomach contents. This process is particularly significant for drugs with high lipid solubility, since these drugs tend to show concentration differences in tissues and blood. Such drugs, e.g. dextropropoxyphene, digoxin, tricyclic antidepressants and phenothiazines, can show increases in excess of 5-fold. Blood collected from the heart and other thoracic or abdominal sites may be similarly affected, and should be avoided wherever possible. Examples of drugs particularly subject to this process include:

• amfetamines

• barbiturates

• cocaine

• chloroquine

• digoxin

• methadone

• phenothiazines

• dextropropoxyphene

 • propranolol

• pethidine

 • tricyclic antidepressants.

The collection of peripheral blood, e.g. femoral or subclavian, reduces the extent of changes, although some increase in blood concentration can still occur. Unequal drug distribution can also occur in the liver due to diffusion from intestinal contents or from incomplete circulation and distribution within the liver.