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Published:
Journal of Analytical Toxicology,
ISSN 0146-4760,
Volume 30, Issue 5, June 2006,
pp.346-351
CASE REPORT: Two Cases of Fatal Amlodipine
Overdose
Jason H. Sklerov[1], Barry Levine[1,2], Kathleen M. Ingwersen[3], Patricia
A. Aronica-Pollack[2], and David Fowler[2]
[1]Division of Forensic Toxicology, Office of the Armed Forces Medical Examiner,
1413 Research Blvd., Rockville, Maryland 20850;
[2]Office of the Chef Medical Examiner, State of Maryland, 111 Penn St., Baltimore,
Maryland 21201; and
[3]Armed Forces Medical Examiner, Landstuhl Regional Medical Center, Landstuhl,
Germany
Two fatal overdoses of the calcium channel blocker amlodipine
are described. Postmortem samples were screened for volatiles and therapeutic
and abused drugs. Amlodipine was measured by liquid chromatography–atmospheric
pressure photoionization-mass spectrometry. The heart blood amlodipine concentrations
for the two cases were 2.4 and 0.95 mg/L, and amlodipine was quantified in all
other tissues. In the first case, venlafaxine and norvenlafaxine were also found,
and the angiotensin receptor antagonist olmesartan was tentatively identified.
The concentrations of amlodipine are compared with previously reported fatal
and nonfatal overdoses. The medical examiners ruled in both cases that the manner
of death was suicide and the causes of death were mixed drug intoxication and
amlodipine intoxication.
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