Lethal suicide attempt with a mixed-drug intoxication of metoprolol and propafenone - A first pediatric case report

Kód výsledku v 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>

Nalezeny alternativní kódy

RIV/00843989:_____/17:E0106502

Výsledek na webu

<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>

Jazyk výsledku

angličtina

Název v původním jazyce

Lethal suicide attempt with a mixed-drug intoxication of metoprolol and propafenone - A first pediatric case report

Popis výsledku v původním jazyce

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.

Název v anglickém jazyce

Lethal suicide attempt with a mixed-drug intoxication of metoprolol and propafenone - A first pediatric case report

Popis výsledku anglicky

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.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30104 - Pharmacology and pharmacy

Projekt

—

Návaznosti

V - Vyzkumna aktivita podporovana z jinych verejnych zdroju

Rok uplatnění

2017

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

FORENSIC SCIENCE INTERNATIONAL

ISSN

0379-0738

e-ISSN

1872-6283

Svazek periodika

—

Číslo periodika v rámci svazku

9/2017

Stát vydavatele periodika

IE - Irsko

Počet stran výsledku

7

Strana od-do

34-40

Kód UT WoS článku

000410033100007

EID výsledku v databázi Scopus

2-s2.0-85023739052