Propranolol and metoprolol : Two comparable drugs with very different post-mortem toxicological profiles

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http://hdl.handle.net/10138/337022

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Kriikku , P , Pelkonen , S , Kaukonen , M & Ojanperä , I 2021 , ' Propranolol and metoprolol : Two comparable drugs with very different post-mortem toxicological profiles ' , Forensic Science International , vol. 327 , 110978 . https://doi.org/10.1016/j.forsciint.2021.110978

Title: Propranolol and metoprolol : Two comparable drugs with very different post-mortem toxicological profiles
Author: Kriikku, Pirkko; Pelkonen, Samu; Kaukonen, Maija; Ojanperä, Ilkka
Contributor organization: Medicum
Department of Forensic Medicine
University of Helsinki
Faculty of Medicine
Date: 2021-10
Language: eng
Number of pages: 5
Belongs to series: Forensic Science International
ISSN: 0379-0738
DOI: https://doi.org/10.1016/j.forsciint.2021.110978
URI: http://hdl.handle.net/10138/337022
Abstract: Propranolol is a widely used beta-blocker mainly prescribed for the treatment of hypertension and other cardiac conditions. This medicine is also a frequent finding in drug screens, but little is known about its post-mortem toxicological profile. Our aim was to examine all post-mortem toxicology cases positive for propranolol in a three-year period, between 2016 and 2018 in Finland, and to compare these cases to those positive for metoprolol, another beta-blocker commonly used to treat cardiac diseases. There were 179 cases positive for propranolol and 416 for metoprolol in the study period. In the majority of propranolol cases (53%), the drug concentration in the blood was above the typical therapeutic range, but among the metoprolol cases this proportion was 18%. Propranolol was significantly more common than metoprolol in fatal poisonings, suicides and in cases with a history of drug abuse. Alcohol, benzodiazepines, antipsychotics and antidepressants were significantly more often detected in propranolol cases than in metoprolol cases. The deceased positive for propranolol were significantly younger than those positive for metoprolol. Cardiovascular diseases as the underlying cause of death were significantly more common among the metoprolol cases than among the propranolol cases. Our results showed significant differences between the propranolol group and the metoprolol group in post-mortem toxicology cases. The two drugs were used by two very different groups of people, with propranolol use being associated with psychiatric conditions.
Description: Publisher Copyright: © 2021 The Author(s)
Subject: Beta-blockers
Drugs
Fatal poisoning
Intoxication
Post-mortem toxicology
Prescription
PSYCHOSIS
TOXICITY
319 Forensic science and other medical sciences
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion


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