Abstract：
Ropinirole is an antiparkinsonian drug and has recently been suggested to be effective in amyotrophic lateral sclerosis. It is expected that ropinirole prescriptions will increase in the near future. However, the fatal concentration in blood is unclear at this time. Therefore, we report a fatal case involving ropinirole intoxication and discuss the fatal concentrations with reference to several autopsy cases involving ropinirole.
Ropinirole was quantified in femoral vein blood, cardiac blood, and urine from five autopsy cases in which ropinirole was detected by drug screening in our laboratory. One is a ropinirole intoxication case (this report) and the others were non-intoxication cases. Their ropinirole concentrations were compared and discussed.
The ropinirole concentration in this case was 100 ng/mL in femoral blood, 160 ng/mL in cardiac blood, and 1840 ng/mL in urine. The ropinirole concentrations in the four non-ropinirole poisoning cases were 7-35 ng/mL (mean: 24 ng/mL) in femoral blood, 13-100 ng/mL (mean: 60 ng/mL) in cardiac blood, and 140-1090 ng/mL (mean: 640 ng/mL) in urine. Cardiac/peripheral ratios were in the range of 1.6-2.1 (mean 1.8).
There were no obvious signs of overdose, and the high cardiac/peripheral blood ratio suggested that postmortem redistribution may have occurred, but the peripheral blood ropinirole concentration (100 ng/mL) was obviously higher than that reported in the previous fatal case of ropinirole poisoning (64 ng/mL). Based on these results, the cause of death in this case was considered to be shock and fatal arrhythmia due to ropinirole poisoning. This case provides important data on postmortem blood and urinary levels of ropinirole poisoning.
Ropinirole was quantified in femoral vein blood, cardiac blood, and urine from five autopsy cases in which ropinirole was detected by drug screening in our laboratory. One is a ropinirole intoxication case (this report) and the others were non-intoxication cases. Their ropinirole concentrations were compared and discussed.
The ropinirole concentration in this case was 100 ng/mL in femoral blood, 160 ng/mL in cardiac blood, and 1840 ng/mL in urine. The ropinirole concentrations in the four non-ropinirole poisoning cases were 7-35 ng/mL (mean: 24 ng/mL) in femoral blood, 13-100 ng/mL (mean: 60 ng/mL) in cardiac blood, and 140-1090 ng/mL (mean: 640 ng/mL) in urine. Cardiac/peripheral ratios were in the range of 1.6-2.1 (mean 1.8).
There were no obvious signs of overdose, and the high cardiac/peripheral blood ratio suggested that postmortem redistribution may have occurred, but the peripheral blood ropinirole concentration (100 ng/mL) was obviously higher than that reported in the previous fatal case of ropinirole poisoning (64 ng/mL). Based on these results, the cause of death in this case was considered to be shock and fatal arrhythmia due to ropinirole poisoning. This case provides important data on postmortem blood and urinary levels of ropinirole poisoning.
摘要：
罗匹尼罗是一种抗帕金森病药物，最近被认为对肌萎缩性侧索硬化症有效。预计罗匹尼罗的处方将在不久的将来增加。然而,此时血液中的致命浓度尚不清楚。因此,我们报告了一例涉及罗匹尼罗中毒的致命病例，并参考几例涉及罗匹尼罗的尸检病例讨论了致命浓度。
股静脉血中的罗匹尼罗被量化，心脏血液,和5例尸检病例的尿液，其中罗匹尼罗在我们实验室通过药物筛查被检测到。一个是罗匹尼罗中毒病例（本报告），其他是非中毒病例。比较并讨论了它们的罗匹尼罗浓度。
在这种情况下，股骨血液中罗匹尼罗的浓度为100ng/mL，心脏血液中160ng/mL，和1840ng/mL的尿液。四例非罗匹尼罗中毒病例中的罗匹尼罗浓度为7-35ng/mL（平均：24ng/mL），心脏血液中13-100ng/mL（平均：60ng/mL），和尿液中140-1090ng/mL（平均：640ng/mL）。心脏/外周比率在1.6-2.1的范围内(平均1.8)。
没有明显的用药过量迹象,高心脏/外周血比率表明死后可能发生了重新分布，但是外周血罗匹尼罗浓度（100ng/mL）明显高于先前致命的罗匹尼罗中毒病例（64ng/mL）。基于这些结果,在这种情况下，死亡原因被认为是休克和致命性心律失常由于罗匹尼罗中毒。此病例提供了有关罗匹尼罗中毒的死后血液和尿液水平的重要数据。
股静脉血中的罗匹尼罗被量化，心脏血液,和5例尸检病例的尿液，其中罗匹尼罗在我们实验室通过药物筛查被检测到。一个是罗匹尼罗中毒病例（本报告），其他是非中毒病例。比较并讨论了它们的罗匹尼罗浓度。
在这种情况下，股骨血液中罗匹尼罗的浓度为100ng/mL，心脏血液中160ng/mL，和1840ng/mL的尿液。四例非罗匹尼罗中毒病例中的罗匹尼罗浓度为7-35ng/mL（平均：24ng/mL），心脏血液中13-100ng/mL（平均：60ng/mL），和尿液中140-1090ng/mL（平均：640ng/mL）。心脏/外周比率在1.6-2.1的范围内(平均1.8)。
没有明显的用药过量迹象,高心脏/外周血比率表明死后可能发生了重新分布，但是外周血罗匹尼罗浓度（100ng/mL）明显高于先前致命的罗匹尼罗中毒病例（64ng/mL）。基于这些结果,在这种情况下，死亡原因被认为是休克和致命性心律失常由于罗匹尼罗中毒。此病例提供了有关罗匹尼罗中毒的死后血液和尿液水平的重要数据。
