Fatal intoxication with ivabradine: First case report
| Autor: | G. Lorin de la Grandamison, C. Mayer-Duverneuil, Jean-Claude Alvarez, C. Rambaud, M. Zerah, A. Knapp-Gisclon |
|---|---|
| Přispěvatelé: | Merlan, Justine, 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], Infection et inflammation (2I), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM) |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Bradycardia
[SDV]Life Sciences [q-bio] Ethyl acetate Poison control Blood concentration 01 natural sciences Pathology and Forensic Medicine 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine medicine Ivabradine 030216 legal & forensic medicine Whole blood Zopiclone business.industry 010401 analytical chemistry medicine.disease 0104 chemical sciences [SDV] Life Sciences [q-bio] Blood pressure chemistry Anesthesia Heart failure medicine.symptom business Law Fatal intoxication Viscera concentrations medicine.drug |
| Zdroj: | Forensic Science International Forensic Science International, Elsevier, 2020, 311, pp.110288. ⟨10.1016/j.forsciint.2020.110288⟩ |
| ISSN: | 0379-0738 |
| Popis: | International audience; Ivabradine is a bradycardic drug used worldwide in the treatment of chronic stable angina and chronic heart failure. We presented here a case of a 61-year-old woman who was admitted to emergency department for overdose. She presented with drowsiness, bradycardia (45bpm) and a low blood pressure (116/21mmHg). She died ten hours after admission from multiple organ failure. Ivabradine was quantified in different matrices sampled during autopsy using a method on LC-MS/MS (TSQ Vantage Thermo Fisher Scientific®), after a double liquid-liquid extraction with a mixture of hexane/ethyl acetate (1/1; v/v) and then chloroform/isopropanol (80/20; v/v). Chromatographic separation was achieved using a Hypersyl gold PFP column (200×2.1mm, 1.9μm) and an acetonitrile/formiate 2mM, 0.1% formic acid buffer gradient. Method was fully validated on whole blood. The mean overall recovery was 90%. Linearity was validated in the 5-500ng/mL range, with intra and inter-day precision lower than 14.3%. The ivabradine concentration found in patient post-mortem blood was 1210ng/mL. Ivabradine was also quantified in different viscera like lung (2910ng/g), kidney (1510ng/g), liver (1050ng/g), heart (900ng/g), and brain (110ng/g). The vitreous humor concentration was 760ng/mL. Pregabalin and zopiclone were also found in blood at 50μg/mL and 206ng/mL, respectively. This case seems to be the first report of a fatal intoxication involving ivabradine and the first published concentrations in organs. |
| Databáze: | OpenAIRE |
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