-
Je něco špatně v tomto záznamu ?
Lethal suicide attempt with a mixed-drug intoxication of metoprolol and propafenone - A first pediatric case report
I. Kacirova, M. Grundmann, M. Kolek, E. Vyskocilova-Hrudikova, R. Urinovska, P. Handlos,
Jazyk angličtina Země Irsko
Typ dokumentu kazuistiky, časopisecké články
NLK
ProQuest Central
od 1997-02-07 do Před 2 měsíci
Nursing & Allied Health Database (ProQuest)
od 1997-02-07 do Před 2 měsíci
Health & Medicine (ProQuest)
od 1997-02-07 do Před 2 měsíci
- MeSH
- antagonisté beta-1-adrenergních receptorů krev otrava MeSH
- antiarytmika krev otrava MeSH
- cerebrální krvácení chemicky indukované MeSH
- edém mozku chemicky indukované MeSH
- kardiogenní šok chemicky indukované MeSH
- lékové interakce MeSH
- lidé MeSH
- metoprolol krev otrava MeSH
- mladiství MeSH
- předávkování léky MeSH
- propafenon krev otrava MeSH
- sebevražda * MeSH
- srdeční zástava chemicky indukované MeSH
- Check Tag
- lidé MeSH
- mladiství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
INTRODUCTION: The β1 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 1g) and propafenone (probably 1.5-3g) 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 10h after ingestion (2630ng/mL metoprolol and 2500ng/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 13.2h 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.
Department of Cardiac Surgery University Hospital Ostrava Ostrava Czech Republic
Department of Clinical Pharmacology Faculty of Medicine University of Ostrava Ostrava Czech Republic
Department of Forensic Medicine University Hospital Ostrava Ostrava Czech Republic
Citace poskytuje Crossref.org
- 000
- 00000naa a2200000 a 4500
- 001
- bmc18033825
- 003
- CZ-PrNML
- 005
- 20181016135608.0
- 007
- ta
- 008
- 181008s2017 ie f 000 0|eng||
- 009
- AR
- 024 7_
- $a 10.1016/j.forsciint.2017.06.025 $2 doi
- 035 __
- $a (PubMed)28716517
- 040 __
- $a ABA008 $b cze $d ABA008 $e AACR2
- 041 0_
- $a eng
- 044 __
- $a ie
- 100 1_
- $a Kacirova, Ivana $u Department of Clinical Pharmacology, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic; Department of Clinical Pharmacology, Department of Laboratory Diagnostics, University Hospital Ostrava, Ostrava, Czech Republic.
- 245 10
- $a Lethal suicide attempt with a mixed-drug intoxication of metoprolol and propafenone - A first pediatric case report / $c I. Kacirova, M. Grundmann, M. Kolek, E. Vyskocilova-Hrudikova, R. Urinovska, P. Handlos,
- 520 9_
- $a INTRODUCTION: The β1 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 1g) and propafenone (probably 1.5-3g) 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 10h after ingestion (2630ng/mL metoprolol and 2500ng/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 13.2h 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.
- 650 _2
- $a mladiství $7 D000293
- 650 _2
- $a antagonisté beta-1-adrenergních receptorů $x krev $x otrava $7 D058671
- 650 _2
- $a antiarytmika $x krev $x otrava $7 D000889
- 650 _2
- $a edém mozku $x chemicky indukované $7 D001929
- 650 _2
- $a cerebrální krvácení $x chemicky indukované $7 D002543
- 650 _2
- $a lékové interakce $7 D004347
- 650 _2
- $a předávkování léky $7 D062787
- 650 _2
- $a ženské pohlaví $7 D005260
- 650 _2
- $a srdeční zástava $x chemicky indukované $7 D006323
- 650 _2
- $a lidé $7 D006801
- 650 _2
- $a metoprolol $x krev $x otrava $7 D008790
- 650 _2
- $a propafenon $x krev $x otrava $7 D011405
- 650 _2
- $a kardiogenní šok $x chemicky indukované $7 D012770
- 650 12
- $a sebevražda $7 D013405
- 655 _2
- $a kazuistiky $7 D002363
- 655 _2
- $a časopisecké články $7 D016428
- 700 1_
- $a Grundmann, Milan $u Department of Clinical Pharmacology, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic. Electronic address: milan.grundmann@osu.cz.
- 700 1_
- $a Kolek, Martin $u Department of Cardiac Surgery, University Hospital Ostrava, Ostrava, Czech Republic.
- 700 1_
- $a Vyskocilova-Hrudikova, Erika $u Department of Clinical Pharmacology, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic; Department of Clinical Pharmacology, Department of Laboratory Diagnostics, University Hospital Ostrava, Ostrava, Czech Republic.
- 700 1_
- $a Urinovska, Romana $u Department of Clinical Pharmacology, Department of Laboratory Diagnostics, University Hospital Ostrava, Ostrava, Czech Republic.
- 700 1_
- $a Handlos, Petr $u Department of Forensic Medicine, University Hospital Ostrava, Ostrava, Czech Republic.
- 773 0_
- $w MED00001844 $t Forensic science international $x 1872-6283 $g Roč. 278, č. - (2017), s. e34-e40
- 856 41
- $u https://pubmed.ncbi.nlm.nih.gov/28716517 $y Pubmed
- 910 __
- $a ABA008 $b sig $c sign $y a $z 0
- 990 __
- $a 20181008 $b ABA008
- 991 __
- $a 20181016140105 $b ABA008
- 999 __
- $a ok $b bmc $g 1340989 $s 1030819
- BAS __
- $a 3
- BAS __
- $a PreBMC
- BMC __
- $a 2017 $b 278 $c - $d e34-e40 $e 20170629 $i 1872-6283 $m Forensic science international $n Forensic Sci Int $x MED00001844
- LZP __
- $a Pubmed-20181008
