Postmortem fatal and non-fatal concentrations of amlodipine

Autor: C. Mayer-Duverneuil, Jean-Claude Alvarez, A. Knapp-Gisclon, G. Lorin de la Grandamison, J. Cappy
Přispěvatelé: Infection et inflammation (2I), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Raymond Poincaré [AP-HP], Médecine légale, Anatomo-pathologie et Paléopathologie [CHU Raymond Poincaré], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP], CCSD, Accord Elsevier
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Male
medicine.medical_specialty
Population
[SHS.ANTHRO-BIO]Humanities and Social Sciences/Biological anthropology
Autopsy
01 natural sciences
Mass Spectrometry
Pathology and Forensic Medicine
Forensic Toxicology
03 medical and health sciences
0302 clinical medicine
Internal medicine
medicine
Humans
Post-mortem redistribution
030216 legal & forensic medicine
Amlodipine
education
Aged
Whole blood
education.field_of_study
business.industry
010401 analytical chemistry
Calcium Channel Blockers
Coronary heart disease
[SHS.ANTHRO-BIO] Humanities and Social Sciences/Biological anthropology
3. Good health
0104 chemical sciences
Blood pressure
Quartile
Post-mortem concentrations
Postmortem Changes
Cardiology
Female
business
Law
Dihydropyridine Calcium Channel Blocker
Chromatography
Liquid
medicine.drug
Zdroj: Forensic Science International
Forensic Science International, Elsevier, 2020, 316, ⟨10.1016/j.forsciint.2020.110555⟩
ISSN: 0379-0738
DOI: 10.1016/j.forsciint.2020.110555⟩
Popis: International audience; Amlodipine is a dihydropyridine calcium channel blocker widely used in the treatment of high blood pressure and coronary heart disease. Intoxication can lead to reflex tachycardia following massive hypotension and death. The objective of this work was to study the post-mortem concentrations of amlodipine in 62 patients in order to determine whether the use of the reference concentrations from the living patients was applicable in postmortem setting, and to define more precisely the fatal and non-fatal postmortem concentrations of amlodipine. The amlodipine concentrations were measured in femoral whole blood by LC–MS/MS validated method. When sufficient information was available, the data were classified into 2 different groups, based on the conclusions of the autopsy and toxicological results: G1: non-toxic death and G2: fatal poisoning involving amlodipine alone or as part of a multidrug poisoning. The median concentration of amlodipine [1st quartile - 3rd quartile] of the whole population (n = 62) was 81 [42–134] ng/mL. Twenty-two cases were classified as G1 and thirteen as G2. The observed median [1st quartile - 3rd quartile] concentration of amlodipine was 66 [40.5–79.5] ng/mL in G1 and 240 [170–404] ng/mL in G2. The median concentrations observed in “non-toxic” deaths (66 ng/mL) were three times higher than those usually observed in living patients. Amlodipine distribution ratio between plasma and whole blood concentrations seems insufficient to explain this difference and postmortem redistribution from organs should be considered, and could suggest the same redistribution pattern for other drugs belonging to the same family.
Databáze: OpenAIRE
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