title: Diltiazem and metoclopramide overdose.
abstract: A fatality resulting from the suicidal ingestion of diltiazem and metoclopramide is described. The decedent was a 25-year-old female with a history of alcoholism and cocaine abuse who overdosed on her mother's medications. On admission she was bradycardiac with severe hypotension and third-degree heart block which progressed to asystole. She was resuscitated but remained comatose until her death four days later. Serum samples from the first 15 h of hospitalization were analyzed for diltiazem and metoclopramide by gas chromatography with nitrogen-phosphorus detection. Diltiazem levels 1 hour post admission were 8.49 mg/L. Diltiazem elimination followed zero-order kinetics with an elimination rate of 0.68 mg/L/h. Metoclopramide levels 1 hour post admission were 4.4 mg/L. Data indicated a biphasic elimination curve for metoclopramide with an initial half-life of 1.3 h and a terminal half-life of 20 h.
authors.affiliation: Office of the Medical Examiner, Rochester, New York 14620.
authors.forename: J M
authors.initials: JM
authors.lastname: Beno
authors.forename: D R
authors.initials: DR
authors.lastname: Nemeth
mesh_terms: D000328:Adult; D002849:Chromatography, Gas; D004110:Diltiazem / Q000032:analysis / Q000506:poisoning*; D062787:Drug Overdose; D005260:Female; D006801:Humans; D008787:Metoclopramide / Q000032:analysis / Q000506:poisoning*; D013405:Suicide
chemical_list: D004110:Diltiazem; D008787:Metoclopramide