An autopsy case of combined drug intoxication involving verapamil, metoprolol and digoxin.
We present here a fatal poisoning case involving verapamil, metoprolol and digoxin. A 39-year-old male was found dead in his room, and a lot of empty packets of prescribed drugs were found near the corpse. The blood concentrations of verapamil, metoprolol and digoxin were 9.2 microg/ml, 3.6 microg/ml and 3.2 ng/ml, respectively. The cause of death was given as cardiac failure, hypotension and bradycardia due to a mixed drug overdose of verapamil, metoprolol and digoxin, based on the results of the autopsy and toxicological examination. We speculate that the toxicity of verapamil is potentiated by drug interaction with metoprolol and digoxin.
Department of Legal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan. kinochin@hyo-med.ac.jp
Hiroshi
H
Kinoshita
Tadaaki
T
Taniguchi
Minori
M
Nishiguchi
Harumi
H
Ouchi
Takako
T
Minami
Takao
T
Utsumi
Hiroyuki
H
Motomura
Toyohiko
T
Tsuda
Takehiko
T
Ohta
Shigeru
S
Aoki
Motoo
M
Komeda
Tetsuji
T
Kamamoto
Akira
A
Kubota
Chiaki
C
Fuke
Tomonori
T
Arao
Tetsuji
T
Miyazaki
Shigeru
S
Hishida
D000319:Adrenergic beta-Antagonists / Q000506:poisoning*; D000328:Adult; D000889:Anti-Arrhythmia Agents / Q000506:poisoning*; D002121:Calcium Channel Blockers / Q000506:poisoning*; D004077:Digoxin / Q000506:poisoning*; D004347:Drug Interactions; D062787:Drug Overdose; D006801:Humans; D008297:Male; D008790:Metoprolol / Q000506:poisoning*; D013405:Suicide; D014700:Verapamil / Q000506:poisoning*
D000319:Adrenergic beta-Antagonists; D000889:Anti-Arrhythmia Agents; D002121:Calcium Channel Blockers; D004077:Digoxin; D014700:Verapamil; D008790:Metoprolol