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Unsuspected self-poisoning with flecainide and alcohol
1Department of Forensic Medicine, Dundee Royal Infirmary, Scotland.
Journal of Forensic Sciences
|September 1, 1995
Summary
This case report details a fatal flecainide and alcohol poisoning in a young man. Toxicological analysis confirmed lethal levels of both substances, highlighting the importance of comprehensive forensic evaluation.
Area of Science:
- Forensic Toxicology
- Clinical Chemistry
- Pharmacology
Background:
- Flecainide is an antiarrhythmic drug with a narrow therapeutic index.
- Co-ingestion of alcohol can potentiate the toxicity of other substances.
- Suicide by drug overdose remains a significant public health concern.
Observation:
- A 23-year-old male presented with fatal flecainide and alcohol poisoning.
- Post-mortem toxicological analysis was performed.
- Various biological samples were collected for drug and alcohol level determination.
Findings:
- Flecainide was identified using ultraviolet spectrophotometry and gas chromatography-mass spectrometry.
- High-performance liquid chromatography quantified flecainide in femoral blood (7.3 mg/L), urine (117 mg/L), stomach contents (19 mg), and liver (302 mg/kg).
- Ethanol levels were elevated in femoral blood (107 mg%), urine (136 mg%), and vitreous humor (113 mg%).
Implications:
- This case underscores the critical role of thorough pathological and toxicological investigations in determining cause of death.
- Accurate quantification of drug and alcohol levels is essential for interpreting overdose cases.
- Understanding the combined effects of flecainide and alcohol is crucial for clinical and forensic practice.