A Tissue Distribution Study of Propafenone in an Intentional Fatal Poisoning Case

Area of Science:

• Analytical Chemistry
• Forensic Toxicology
• Pharmacology

Background:

• Propafenone (PPF), a class 1C antiarrhythmic, can cause significant adverse effects.
• Investigating propafenone intoxication cases is rare, limiting understanding of its toxicokinetics.
• Accurate quantification of PPF in complex post-mortem matrices is challenging.

Observation:

• A novel, selective GC-MS/MS method was developed for propafenone determination.
• The method allows quantification across therapeutic to lethal concentrations in post-mortem samples.
• A unique sample pretreatment enabled analysis without dilution, even in complex matrices.

Findings:

• The highest reported serum propafenone concentration was observed pre-therapy in a fatal poisoning case.
• Fatal or abnormally high propafenone levels were detected in lungs, spleen, and cardiac/femoral blood post-intensive therapy.
• Liver and skeletal muscle propafenone concentrations were comparable to therapeutic dose cases.

Implications:

• This validated method is applicable for propafenone quantification in clinical and forensic toxicology.
• The tissue distribution data in this fatal case offers crucial insights into propafenone toxicity.
• Understanding propafenone distribution in fatal intoxications can guide clinical management and forensic investigations.