She had 7909 ng/mL, not mg (nanograms per milliliters, not milligrams), which converts to 7.909 mg/liter (milligrams per liter). Estimate 5 or 6 liters (probably less, since she was small) of blood in her body, that would come out to 39.5 to 47.5 mg of the drug in her system. People were given an average of about 75 mg a day in divided doses for depression, so the amount in her system isn't nearly as large as it sounds.
It wasn't until you mentioned it that I went back and noticed it was nanograms, not milligrams.
The nortriptyline is also a relatively small amount.
I couldn't find how much Flexeril was found.
Now I'm wondering why EITHER pathologist would call this amitriptiyline toxicity when the dosage found was less than the average dose given an adult for depression.
Either my math is way off, or I'm reading something wrong, or I'm missing something vital.
Anyone want to chime in, because I just totally confused myself . . . :dunno: