Problems of Forensic Sciences 2004 Vol. 58 (LVIII) 112-120
DETERMINATION OF ENANTIOMERS OF VERAPAMIL IN A CASE OF ACUTE POISONING
Wojciech PIEKOSZEWSKI1,2, Jolanta WILIMOWSKA2, Ewa KRZYŻANOWSKA-KIEREPKA3, Ewa FLOREK4
1Institute of Forensic Research, Cracow
2Department of Analytical Toxicology and Therapeutic Drug Monitoring, Collegium Medicum, Jagiellonian University, Cracow
3Toxicology Clinic, Collegium Medicum, Jagiellonian University, Cracow
4Laboratory of Environmental Research, Department of Toxicology, University of Medical Sciences, Poznań
Streszczenie
A 52-year-old woman with a history of depression with personality disorders, hypertension, coronary disease and asthma was admitted to the Toxicology Clinic after taking sixty tablets of Staveran and four tablets of analgesics. One and a half hours after ingestion, her condition was critical. She required endotracheal intubation and artificial respiration. Her heart rate was 75 beats per minute and her blood pressure dropped from 70/50 to 50/00 mm Hg. Additionally, drowsiness and headache were observed. On admission, the verapamil R-(+)- and S-(–)-enantiomers serum concentrations were 2.3 μg/ml and 0.8 μg/ml, respectively. Monitoring of the verapamil serum concentration was carried out over a period of 74 hours. Terminal elimination half-lives were 18.7 hours and 17.0 hours respectively for R-(+)- and S-(–)-verapamil enantiomers. The ratio of enantiomer S/R concentrations was concentration dependent and decreased in parallel with decrease of verapamil concentration. Monitoring of verapamil enantiomers concentration in serum indicated a higher concentration of the less active form and faster elimination of the more active enantiomer.
Słowa kluczowe
Chiral liquid chromatography; Verapamil overdose; Pharmacokinetics.