Lethal suicide attempt with a mixed-drug intoxication of metoprolol and propafenone - A first pediatric case report
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F61988987%3A17110%2F17%3AA1801RUN" target="_blank" >RIV/61988987:17110/17:A1801RUN - isvavai.cz</a>
Alternative codes found
RIV/00843989:_____/17:E0106502
Result on the web
<a href="http://dx.doi.org/10.1016/j.forsciint.2017.06.025" target="_blank" >http://dx.doi.org/10.1016/j.forsciint.2017.06.025</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.1016/j.forsciint.2017.06.025" target="_blank" >10.1016/j.forsciint.2017.06.025</a>
Alternative languages
Result language
angličtina
Original language name
Lethal suicide attempt with a mixed-drug intoxication of metoprolol and propafenone - A first pediatric case report
Original language description
Introduction: The beta 1 adrenergic receptor blocker metoprolol is often prescribed together with the antiarrhythmic drug propafenone. Both are metabolized by cytochrome P450 2D6 and propafenone is also an inhibitor of this enzyme. We present a pediatric case showing metoprolol and propafenone intoxication in combination.Case: A 14-year-old girl was admitted to a local emergency department after ingestion of metoprolol (probably 1 g) and propafenone (probably 1.5-3 g) in a suicide attempt. She developed cardiogenic shock with cardiac arrest and was fully resuscitated. Veno-arterial femorofemoral extracorporeal membrane oxygenation was started immediately. High serum levels of both drugs were detected approximately 10 h after ingestion (2630 ng/mL metoprolol and 2500 ng/mL propafenone). Other serial samples for the monitoring of the levels of metoprolol and its metabolite alfa-hydroxymetoprolol were obtained between days 2 and 4 after admission. The metoprolol/alfa-hydroxymetoprolol ratio on the 2nd day was 36.1, indicative of a poor metabolizer phenotype. The elimination half-life of metoprolol was prolonged to 13.2 h and the clearance decreased by about 70%. The patient condition gradually worsened, brain edema and intracerebral hemorrhage occurred, and on the 6th day, the patient died.Conclusion: We document a pediatric case report of death due to a mixed drug overdose of metoprolol and propafenone, along with data regarding serum metoprolol, alfa-hydroxymetoprolol, and propafenone levels. (C) 2017 Elsevier B. V. All rights reserved.
Czech name
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Czech description
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Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
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OECD FORD branch
30104 - Pharmacology and pharmacy
Result continuities
Project
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Continuities
V - Vyzkumna aktivita podporovana z jinych verejnych zdroju
Others
Publication year
2017
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
FORENSIC SCIENCE INTERNATIONAL
ISSN
0379-0738
e-ISSN
1872-6283
Volume of the periodical
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Issue of the periodical within the volume
9/2017
Country of publishing house
IE - IRELAND
Number of pages
7
Pages from-to
34-40
UT code for WoS article
000410033100007
EID of the result in the Scopus database
2-s2.0-85023739052