To be totally honest that level of medicine is beyond my scope, but I’ve never seen or heard of anything like that happening. I regularly administer fentanyl for sedation and pain control just to give you an idea of where I’m coming from.
Just a guess but what I think happened is Kirby’s heightened metabolism and muscle activity caused a spike in serum potassium levels. The effect of that on his already over taxed and diseased heart caused his cardiac arrest.
Hyperkalemia (High serum potassium) is one of the reversible causes we consider when attempting to revive someone in cardiac arrest.
I'm not a doctor or even in medicine, so, always grateful for someone's opinion who probably knows more about such things.
Hyperkalemia or some form of heightened metabolism is kinda what I was trying to draw towards. If the RoA was rectal or he swallowed potential 'evidence' as it were... I mean, he was in the 'excited delirium' for a time period of minutes. I don't think he just dosed fentanyl, because AFAIK (I'm a layman) there is no paradoxical reaction from a boatload of fentanyl with any other given RoA.
The supposed (I'm skeptical of everything, especially these days) toxicology reports I keep seeing on a basic search says for Kirby:
Methamphetamine: 19 ng/mL via blood tested by LC-MS/MS.
I'm not a toxicologist so I don't know if 19ng/mL is a shitload of blood level of methamp. or not. No point of reference. Not even sure if the tox report is legit but taking these two contradictive and powerful drugs (in their respective classes and pharmokinetic function) even with a hearty tolerance is dangerous as hell. It's how people end up dead.
My interest in the medicine is piqued.
What's interesting is: if we can determine that 19 ng/mL plasma concentration is akin to eating or shoving x amount of nickel/dime/$5/$10 bags up your ass/down your throat, then the who restrain/knee thing is basically a non-starter as an argument. Not that most people here seem to buy that argument and neither do I (nor does the autopsy)... but the normies, y'know?
Tweaking meth with ballon of fentanyl laced smack up his ass/down his throat that gets into the blood stream right about the time he gets tossed on the ground by the cops.
Cops think he passed out/finally gave up, but in actuality it’s respiratory arrest.
It’s above my head but I’d be interested to see what someone who understands it has to say.
With fentanyl, we shoot for 1-2ng/ml for pain control and 10-11ng/ml for full sedation. The average, non-tolerant male begins to experience the respiratory arrest to the point of needing either ventilatory support or naloxone is in the range of 7ng/ml.
Fentanyl LD50 is in the range of 2mg for a 75kg male.
LD50 for meth is 150mg. Same 75kg male.
But agitated delirium is a whole separate process and isn’t necessarily dose dependent.
No clue how to translate either number into ng/ml and it would vary person to person, but 2+mg of fentanyl laced in a bag of smack seems pretty reasonable in my uninitiated opinion.
Edit to add I’d be interested to see a full blood/tox panel from the autopsy. Not gonna pretend that I know more that a medical examiner, but I bet it’s probably pretty telling.
To be totally honest that level of medicine is beyond my scope, but I’ve never seen or heard of anything like that happening. I regularly administer fentanyl for sedation and pain control just to give you an idea of where I’m coming from.
Just a guess but what I think happened is Kirby’s heightened metabolism and muscle activity caused a spike in serum potassium levels. The effect of that on his already over taxed and diseased heart caused his cardiac arrest.
Hyperkalemia (High serum potassium) is one of the reversible causes we consider when attempting to revive someone in cardiac arrest.
I'm not a doctor or even in medicine, so, always grateful for someone's opinion who probably knows more about such things.
Hyperkalemia or some form of heightened metabolism is kinda what I was trying to draw towards. If the RoA was rectal or he swallowed potential 'evidence' as it were... I mean, he was in the 'excited delirium' for a time period of minutes. I don't think he just dosed fentanyl, because AFAIK (I'm a layman) there is no paradoxical reaction from a boatload of fentanyl with any other given RoA.
The supposed (I'm skeptical of everything, especially these days) toxicology reports I keep seeing on a basic search says for Kirby:
I'm not a toxicologist so I don't know if 19ng/mL is a shitload of blood level of methamp. or not. No point of reference. Not even sure if the tox report is legit but taking these two contradictive and powerful drugs (in their respective classes and pharmokinetic function) even with a hearty tolerance is dangerous as hell. It's how people end up dead.
My interest in the medicine is piqued.
What's interesting is: if we can determine that 19 ng/mL plasma concentration is akin to eating or shoving x amount of nickel/dime/$5/$10 bags up your ass/down your throat, then the who restrain/knee thing is basically a non-starter as an argument. Not that most people here seem to buy that argument and neither do I (nor does the autopsy)... but the normies, y'know?
TL;DR ver: contradictive drugs are dangerous yo
That’s definitely a thought.
Tweaking meth with ballon of fentanyl laced smack up his ass/down his throat that gets into the blood stream right about the time he gets tossed on the ground by the cops.
Cops think he passed out/finally gave up, but in actuality it’s respiratory arrest.
It’s above my head but I’d be interested to see what someone who understands it has to say.
With fentanyl, we shoot for 1-2ng/ml for pain control and 10-11ng/ml for full sedation. The average, non-tolerant male begins to experience the respiratory arrest to the point of needing either ventilatory support or naloxone is in the range of 7ng/ml.
Fentanyl LD50 is in the range of 2mg for a 75kg male.
LD50 for meth is 150mg. Same 75kg male.
But agitated delirium is a whole separate process and isn’t necessarily dose dependent.
No clue how to translate either number into ng/ml and it would vary person to person, but 2+mg of fentanyl laced in a bag of smack seems pretty reasonable in my uninitiated opinion.
Edit to add I’d be interested to see a full blood/tox panel from the autopsy. Not gonna pretend that I know more that a medical examiner, but I bet it’s probably pretty telling.