Fatal flecainide intoxication.
A fatal case attributed to flecainide acetate (Tambocor), a class Ic antiarrythmic drug, is presented. Flecainide was detected by GC/MS in gastric contents, blood and liver as well. The urine analysis revealed the presence of its dealkylated metabolite. Body fluids and tissue concentrations determined by GC/ECD were 7.7 mg/kg in femoral blood, 0.26 mg/kg in bile, 18 mg/kg in liver, 0.17 mg/kg in cerebrospinal fluid, 0.22 mg/kg in brain cortex and 28.9 mg/kg in urine. The total amount of flecainide in gastric contents was about 43 mg. Even taking into account the postmortem redistribution of flecainide, its blood level still remains in the toxic range.
Romain
N
N
Institut Universitaire de Médecine Légale de Lausanne, Switzerland.
Giroud
C
C
Michaud
K
K
Augsburger
M
M
Mangin
P
P
D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000032:analysis / Q000097:blood / Q000134:cerebrospinal fluid / Q000506:poisoning* / Q000652:urine; D001646:Bile / Q000737:chemistry; D001826:Body Fluids / Q000737:chemistry; D002540:Cerebral Cortex / Q000737:chemistry; D062787:Drug Overdose; D017809:Fatal Outcome; D005424:Flecainide / Q000032:analysis / Q000097:blood / Q000134:cerebrospinal fluid / Q000506:poisoning* / Q000652:urine; D008401:Gas Chromatography-Mass Spectrometry; D005766:Gastrointestinal Contents / Q000737:chemistry; D006801:Humans; D008099:Liver / Q000737:chemistry; D008297:Male; D013405:Suicide; D014018:Tissue Distribution
D000889:Anti-Arrhythmia Agents; D005424:Flecainide