TY  - JOUR
PY  - 2016//
TI  - Fatal intoxications due to administration of isosorbide tablets contaminated with pyrimethamine
JO  - Journal of forensic sciences
A1  - Imran, Muhammad
A1  - Shafi, Humera
A1  - Mahmood, Zahid
A1  - Sarwar, Mohammad
A1  - Usman, Hafiz Faisal
A1  - Tahir, Mohammad Ashraf
A1  - Ashiq, Muhammad Zar
SP  - 1382
EP  - 1385
VL  - 61
IS  - 5
N2  - In January 2012, 664 cases of pyrimethamine toxicity and 151 deaths were reported among cardiac patients that had recently received free medicines from pharmacy of Punjab Institute of Cardiology, Lahore, Pakistan. These patients, ages ranged from 58 to 75 years, were prescribed simvastatin, clopidogrel, aspirin soluble, isosorbide mononitrate, and amlodipine. On examination of medications being given to them, it was found that a particular batch of isosorbide mononitrate tablets was contaminated with 50 mg pyrimethamine. Cardiac patients were taking isosorbide contaminated with pyrimethamine twice daily (100 mg pyrimethamine/day), whereas therapeutic dose of pyrimethamine for malaria is 25 mg/week. Postmortem urine, cardiac blood, and femoral blood specimens of three deceased males were submitted to author's laboratory for analysis. Postmortem toxicological analysis revealed that pyrimethamine concentration fell within the range of 1-10 μg/mL by liquid chromatography. Clinical, autopsy, histopathological, and toxicological findings strongly suggested toxicity due to pyrimethamine accumulation that resulted in deaths of these cardiac patients.<br><br>© 2016 American Academy of Forensic Sciences.<p />  <p>Language: en</p>
LA  - en
SN  - 0022-1198
UR  - http://dx.doi.org/10.1111/1556-4029.13125
ID  - ref1
ER  -