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Dr. Owen
Dr. Owen, Board Certified Physician
Category: Medical
Satisfied Customers: 55754
Experience:  Board Certified in 2 Specialities & US Medical Graduate
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In my sisters autopsy 736 ng/mL of alprazolam was found. I

Resolved Question:

In my sisters autopsy 736 ng/mL of alprazolam was found. I would like to know how many 2MG tablets she would have had to have taken?
Submitted: 7 years ago.
Category: Medical
Expert:  Dr. Owen replied 7 years ago.
This depends when she took them and when she died?
And, it is hard to convert a mass in mg to a density (mg/dL) - and you would have to know her weight and height and total volume of blood in her body too.
Customer: replied 7 years ago.
I have the answers to all these questions.
Expert:  Dr. Owen replied 7 years ago.
If you have information - please fill me in - thank you.
Customer: replied 7 years ago.

VI. Obesity (BMI = 31.0)

Height 67 in.

Weight 90 kg.

It does not show in the autopsy the total volume of blood in her body.

The autopsy states "accident". She took the pills aprox. 2-3 hours prior to death.

Expert:  Dr. Owen replied 7 years ago.
So is this considered an overdose?
Customer: replied 7 years ago.

Yes, they say accidental overdose. That's why I want to know how many pills were taken?

I. Heart (460 g)

A. No significant atherosclerosis of coronary arteries

II. Pulmonary congestion and edema (combined weight 1430 g)

III. Liver with fatty metamorphosis

IV. Urinary bladder with approximately 200 cc of retained urine

V. Cholecystectomy, remote

VI. Obesity (BMI = 31.0)

VII. No fatal trauma identified

COMMENT: Toxicological analysis of femoral blood revealed an alprazolam level of 736 ng/mL.

Expert:  Dr. Owen replied 7 years ago.
I will assume she had the average blood volume of 5 liters - 5000 ml - so this means she had 736ng/mL x 5000mL = 3,680,000ng of medication.
1 gram = 1,000,000,000 ng
1 gram = 1,000mg
Therefore 3,680,000ng x 1000mg/1,000,000,000 = 3.68 mg in her blood stream - and this is a lot - so even though the tablets were 2mg - given that it had to get into her blood stream too - she probably had a few hours - so most likely she had about 30 to 50 tablets in her body - so about 60 to 100mg of medication to equal just the 3.68mg in her blood. Quite an overdose - this was no accident - sorry.
I hope this helps,
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