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

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A Correction to this article was published on 24 May 2019

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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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Change history

  • 24 May 2019

    The published version of this article unfortunately contained a mistake. In Figure 1 on the molecular network of acebutololol, two molecular structures are not displayed (“acebutolol glucuronide “and “impurity J”). The Figure is corrected here.

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Authors and Affiliations

  1. INSERM, INRA, CHU Rennes, Institut NuMeCan (Nutrition, Metabolism and Cancer), University Rennes, 35000, Rennes, France

    Brendan Le Daré, Isabelle Morel & Thomas Gicquel

  2. Pharmacy Service, Rennes University Hospital, 35000, Rennes, France

    Brendan Le Daré

  3. Forensic Toxicology Laboratory, Rennes University Hospital, 35000, Rennes, France

    Sophie Allard, Isabelle Morel & Thomas Gicquel

  4. Department of Forensic Medicine, Rennes University Hospital, 35000, Rennes, France

    Renaud Bouvet & Alain Baert

  5. IDPSP - EA 4640, University Rennes, 35000, Rennes, France

    Renaud Bouvet

  6. School of Pharmaceutical Sciences, University of Geneva and University of Lausanne, Geneva, Switzerland

    Pierre-Marie Allard

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  1. Brendan Le Daré
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  2. Sophie Allard
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  3. Renaud Bouvet
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  4. Alain Baert
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  5. Pierre-Marie Allard
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  6. Isabelle Morel
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  7. Thomas Gicquel
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Correspondence to Brendan Le Daré.

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Le Daré, B., Allard, S., Bouvet, R. et al. A case of fatal acebutolol poisoning: an illustration of the potential of molecular networking. Int J Legal Med 134, 251–256 (2020). https://doi.org/10.1007/s00414-019-02062-9

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  • DOI: https://doi.org/10.1007/s00414-019-02062-9

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