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

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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Submitted on : Monday, May 6, 2019 - 11:43:49 AM
Last modification on : Thursday, June 27, 2019 - 1:26:09 PM

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Brendan Le Dare, Sophie Allard, Renaud Bouvet, Alain Baert, Pierre-Marie Allard, et al.. A case of fatal acebutolol poisoning an illustration of the potential of molecular networking. International Journal of Legal Medicine, Springer Verlag, 2019, ⟨10.1007/s00414-019-02062-9⟩. ⟨hal-02120883⟩

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