
rs asked: Jane Doe, 28 year old, healthy. has parkinson white syndrome, Physical Exam- normal BP122/78, HR -71, Lab- normal, has reoccurant head aches, and is going thru anti migrant therapy, not effective. new HMO, put her on amitriptyline week 1-10mg/day@bedtime, week 2 -20 mg/day@bedtime, week -3 50mg/day@ bedtime and week 4 increased his dosage to 100mg/day @ bedtime. and Nortriptyline 0.05mg/L. Jane doe followed the dosage regiment but no follow up with her HMO, two days later, playing soft ball, Jane Doe rushes to catch the ball, jumps up, pops up ,throws the ball and collapses.CPR given. with in 5 mintues the paramatics arrive, unable to revive. No stroke, No MI, No injury, caffine in the system, urine screen negative.Autopsy no apparent cause of death? comment on the drug amitriptyline and reasonable dosage? Toxicity?
whats the cause of death? do you think amitriptyline contributed to his death? if yes why? Is the HMO at fault? if no explain how an healthy, 28 year old , drop dead?