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10.3390/separations10020068
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Case Report

Acute Intoxication by Bisoprolol and Drowning: Toxicological Analysis in Complex Suicides

by
Anna Carfora
*,
Raffaella Petrella
,
Giusy Ambrosio
,
Ilaria Fracassi
,
Stefano Festinese
,
Bruno Liguori
and
Carlo Pietro Campobasso
Forensic Toxicology Unit, Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Via Luciano Armanni, 80138 Naples, Italy
*
Author to whom correspondence should be addressed.
Separations 2023, 10(2), 68; https://doi.org/10.3390/separations10020068
Submission received: 15 December 2022 / Revised: 28 December 2022 / Accepted: 16 January 2023 / Published: 18 January 2023
(This article belongs to the Collection Separation and Analysis of Drugs and Poisons in Forensic Science)
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Abstract

In complex suicides, more than one suicide method is applied at the same time or one after the other. The most common complex suicide includes the ingestion of drugs combined with drowning. A case of acute intoxication by Bisoprolol and drowning is reported. The dead body of a 40-year-old woman was discovered on a river side, soon after her husband found a suicide note at home. In the woman’s vehicle four empty boxes of Bisoprolol, a widely used beta blocker, were also found. Main autopsy findings were consistent with drowning and represented by plume of froth at the mouth and nostrils with frothy fluid also in the airways, water into the stomach, and a remarkable pulmonary edema as a result of fluid aspiration. Toxicological analyses were performed on peripheral blood, urine and gastric content samples using liquid and gas chromatography, coupled with mass spectrometry. Toxicological results were negative for ethanol and other common drugs of abuse. High levels of bisoprolol were found in blood (7.54 mg/L), far exceeding the therapeutic range, in the urine (1.14 mg/L), and gastric content (13.12 mg/L). Bisoprolol intoxication was assessed as a relevant contributing condition to the immediate cause of death represented by drowning. Although Bisoprolol would certainly have a heart-depressing effect, it is not possible to determine if the victim fell unconscious or if she simply collapsed into the water with a secondary drowning.
Keywords: complex suicides; beta blocker; drowning; bisoprolol intoxication complex suicides; beta blocker; drowning; bisoprolol intoxication

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MDPI and ACS Style

Carfora, A.; Petrella, R.; Ambrosio, G.; Fracassi, I.; Festinese, S.; Liguori, B.; Campobasso, C.P. Acute Intoxication by Bisoprolol and Drowning: Toxicological Analysis in Complex Suicides. Separations 2023, 10, 68. https://doi.org/10.3390/separations10020068

AMA Style

Carfora A, Petrella R, Ambrosio G, Fracassi I, Festinese S, Liguori B, Campobasso CP. Acute Intoxication by Bisoprolol and Drowning: Toxicological Analysis in Complex Suicides. Separations. 2023; 10(2):68. https://doi.org/10.3390/separations10020068

Chicago/Turabian Style

Carfora, Anna, Raffaella Petrella, Giusy Ambrosio, Ilaria Fracassi, Stefano Festinese, Bruno Liguori, and Carlo Pietro Campobasso. 2023. "Acute Intoxication by Bisoprolol and Drowning: Toxicological Analysis in Complex Suicides" Separations 10, no. 2: 68. https://doi.org/10.3390/separations10020068

APA Style

Carfora, A., Petrella, R., Ambrosio, G., Fracassi, I., Festinese, S., Liguori, B., & Campobasso, C. P. (2023). Acute Intoxication by Bisoprolol and Drowning: Toxicological Analysis in Complex Suicides. Separations, 10(2), 68. https://doi.org/10.3390/separations10020068

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