Cardiovascular drugs and suicide death: Determination of carvedilol, amlodipine, doxazosin and diltiazem in two fatal cases

A number of medical conditions are identified as risk factors for suicide death; in particular, cardiovascular illnesses are recognized as a major suicide risk factor. In this case, self-poisoning is the common method of suicide and cardiovascular drugs are among the major medications associated wit...

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Bibliographic Details
Published in:Journal of pharmaceutical and biomedical analysis 2024-01, Vol.238, p.115831-115831, Article 115831
Main Authors: Santunione, A.L., Palazzoli, F., Verri, P., Vandelli, D., Castagnetti, V., Profeta, C., Silingardi, E.
Format: Article
Language:English
Subjects:
Cardiovascular drugs
LC-MS/MS
Post-mortem specimens
Suicide
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Summary:A number of medical conditions are identified as risk factors for suicide death; in particular, cardiovascular illnesses are recognized as a major suicide risk factor. In this case, self-poisoning is the common method of suicide and cardiovascular drugs are among the major medications associated with fatal overdose, with calcium channel blockers being one of the most common agents. The present study describes two different fatal suicide cases involving four cardiovascular drugs: carvedilol, doxazosin and amlodipine (case 1) and diltiazem (case 2). The concentrations of the target cardiovascular drugs in the different biological specimens (central and femoral blood, urine, liver, brain) are presented, giving information about the potentially fatal data and the distribution of the drugs in the body. The study led to the implementation of a fast, sensitive and simple method for the detection and quantification of the four commonly prescribed cardiovascular drugs in post-mortem specimens including fluids and tissues for forensic purposes. The method was fully validated. The toxicological results of the studied cases are discussed, along with the autopsy results, histopathological evidence, and circumstances of death. The toxicological findings presented in the study provide new data regarding cardiovascular drugs in different post-mortem specimens, which will contribute to the currently limited knowledge about the toxicological profile of cardiovascular drugs and their distribution. •Two fatal suicide cases involving cardiovascular drugs are presented.•A fully validated LC-MS/MS method applied in postmortem specimens for cardiovascular drugs is described.•Information about distribution and potentially toxic to lethal concentrations of the drugs are given.•The toxicological findings provide new data regarding cardiovascular drugs in different post-mortem specimens, contributing to the currently limited knowledge.
ISSN:0731-7085
1873-264X
DOI:10.1016/j.jpba.2023.115831