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Flecainide intoxication.

B Levine1, D Chute, Y H Caplan

  • 1Office of the Chief Medical Examiner, State of Maryland, Baltimore, Maryland 21201.

Journal of Analytical Toxicology
|September 1, 1990
PubMed
Summary
This summary is machine-generated.

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This case report details a fatal flecainide intoxication. Blood flecainide levels were significantly elevated, confirming toxic overdose and aiding in forensic analysis.

Area of Science:

  • Forensic Toxicology
  • Clinical Pharmacology
  • Analytical Chemistry

Background:

  • Flecainide is an antiarrhythmic drug used to treat cardiac arrhythmias.
  • Therapeutic drug monitoring is crucial for optimizing patient outcomes and preventing toxicity.
  • Understanding toxicological thresholds is vital for interpreting overdose cases.

Observation:

  • A fatal case of flecainide intoxication was investigated.
  • Capillary gas chromatography with nitrogen-phosphorus detection was employed for quantitative analysis.
  • Elevated flecainide concentrations were measured in various biological specimens.

Findings:

  • Blood flecainide concentration was 13 mg/L, vastly exceeding the therapeutic serum range of 0.2-1.0 mg/L.
  • High concentrations were also detected in bile (160 mg/L), urine (54 mg/L), vitreous humor (7.4 mg/L), liver (180 mg/kg), kidney (74 mg/kg), and stomach contents (120 mg).

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Implications:

  • This case highlights the potential for severe toxicity with flecainide overdose.
  • Accurate toxicological quantitation is essential for confirming cause of death in suspected intoxication cases.
  • The distribution of flecainide in post-mortem samples provides valuable data for forensic investigations.