A report of a mixed oral overdose documented a plasma duloxetine concentration of 57 ng/mL in a specimen taken during ambulance transport and 126 ng/mL approximately 32 hours after ingestion. Other drugs were also involved. The authors compared the measured concentrations with simulations from a physiologically based pharmacokinetic model.
The later sample establishes that the concentration at that time exceeded the earlier measurement. It does not identify the highest concentration or its timing. Ongoing absorption, formulation and other features of the overdose can complicate the relationship between a sample time and the course of exposure. Agreement with a model interval does not determine which of these factors explains the case.
Place the reported ingestion time, specimen collections and treatment events on one timeline. Label any model curve as a prediction and specify its assumptions. Where only a few samples are available, describe the concentration changes the samples actually show.
Adachi et al., Journal of Pharmaceutical Health Care and Sciences (2021) ยท Full text