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Fatal flecainide intoxication.

N Romain1, C Giroud, K Michaud

  • 1Institut Universitaire de Médecine Légale de Lausanne, Switzerland.

Forensic Science International
|February 9, 2000
PubMed
Summary
This summary is machine-generated.

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A fatal case highlights the toxicity of flecainide acetate, an antiarrhythmic drug. High concentrations found in tissues and blood indicate a toxic range, even after considering postmortem redistribution.

Area of Science:

  • Forensic Toxicology
  • Clinical Pharmacology

Background:

  • Flecainide acetate is a potent Class Ic antiarrhythmic medication.
  • Understanding its toxicological profile is crucial for clinical and forensic settings.

Observation:

  • A fatal case involving flecainide acetate overdose is detailed.
  • The drug and its metabolite were identified in various biological samples using Gas Chromatography-Mass Spectrometry (GC/MS) and Gas Chromatography-Electron Capture Detection (GC/ECD).

Findings:

  • Significant concentrations of flecainide were quantified in gastric contents (43 mg), liver (18 mg/kg), femoral blood (7.7 mg/kg), and urine (28.9 mg/kg).
  • A dealkylated metabolite of flecainide was detected in urine.
  • Postmortem redistribution was considered, but blood flecainide levels remained within the toxic range.

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Implications:

  • This case underscores the potential for flecainide acetate toxicity and the importance of accurate toxicological analysis.
  • Establishing reference ranges for flecainide in postmortem cases is vital for accurate interpretation of results.
  • Highlights the need for careful dosing and monitoring of flecainide acetate to prevent adverse events.