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Published in: International Journal of Legal Medicine 1/2020

01-01-2020 | Autopsy | Case Report

A case of fatal acebutolol poisoning: an illustration of the potential of molecular networking

Authors: Brendan Le Daré, Sophie Allard, Renaud Bouvet, Alain Baert, Pierre-Marie Allard, Isabelle Morel, Thomas Gicquel

Published in: International Journal of Legal Medicine | Issue 1/2020

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Abstract

Acebutolol is a β1-selective adrenergic receptor antagonist with moderate membrane-stabilizing activity and intrinsic sympathomimetic activity; accordingly, the drug is indicated in hypertension, angina pectoris, and arrhythmia. However, acebutolol’s beta-blocking properties also extend the QRS and QTc intervals, and may predispose the patient to ventricular tachydysrhythmia. Here, we report autopsy and toxicological findings on a fatal case of acebutolol self-poisoning in a 70-year-old woman. Toxicological analyses of post-mortem samples (using a liquid chromatography high-resolution mass spectrometry (LC-HR-MS) method) highlighted high concentrations of acebutolol and its metabolite diacetolol in femoral blood (92.8 mg/L and 21.2 mg/L, respectively) and other matrices (cardiac blood, urine, bile, and gastric contents). A molecular networking approach provided useful information on acebutolol’s metabolism and revealed the existence of an unknown phase II metabolite of acebutolol. Molecular networking also facilitated visualization of the complex LC-HR-MS/MS datasets and the sample-to-sample comparisons that confirmed massive acebutolol intoxication by ingestion.
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Metadata
Title
A case of fatal acebutolol poisoning: an illustration of the potential of molecular networking
Authors
Brendan Le Daré
Sophie Allard
Renaud Bouvet
Alain Baert
Pierre-Marie Allard
Isabelle Morel
Thomas Gicquel
Publication date
01-01-2020
Publisher
Springer Berlin Heidelberg
Published in
International Journal of Legal Medicine / Issue 1/2020
Print ISSN: 0937-9827
Electronic ISSN: 1437-1596
DOI
https://doi.org/10.1007/s00414-019-02062-9

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