Cases detected with sildenafil/tadalafil/vardenafil in autopsies performed in Muğla: retrospective evaluation
DOI:
https://doi.org/10.17986/blm.1740Keywords:
Postmortem toxicology, Sildenafil, AutopsyAbstract
Objective: In this study, it was aimed to discuss the cases that were detected with phosphodiesterase 5 (PDE-5) inhibitors in autopsies performed, the mechanisms that may affect death, the aspects to be paid attention and protective measures in autopsy of these cases, and to investigate whether the use of PDE-5 inhibitors has cardiac side effects. Materials and Methods: Cases in which PDE-5 inhibitors were found in body fluids in toxicological examinations among autopsies performed in the 8-year period between January 01, 2013 and December 31, 2023 in Mugla Forensic Medicine Branch Office were retrospectively evaluated. Results: Sildenafil/vardenafil/tadalafil were detected in 49 (0.9%) of 5,277 autopsy cases. Sudden/suspicious deaths were the most common reason for sending the cases to autopsy. This was followed by drowning, traffic accidents and hangings, respectively. The most common cause of death in cases using PDE-5 inhibitors was atherosclerotic cardiovascular disease/ myocardial infarction (n:22, 44.8%). Conclusion: In our study, it was determined that more than 44.8% of the cases with PDE-5 inhibitors in the autopsy had cardiovascular diseases. It suggests that PDE-5 inhibitors may have caused risky cardiac side effects. It is considered that the present study will contribute to the literature in terms of showing the cardiac side effects of PDE-5 inhibitor.
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Langtry HD, Markham A: Sildenafil. Drugs 1999, 57(6):967-989. DOI: https://doi.org/10.2165/00003495-199957060-00015 DOI: https://doi.org/10.2165/00003495-199957060-00015
Boyce EG, Umland EM: Sildenafil citrate: a therapeutic update. Clinical therapeutics 2001, 23(1):2-23. DOI: https://doi.org/10.1016/s0149-2918(01)80027-8 DOI: https://doi.org/10.1016/S0149-2918(01)80027-8
DeBusk R, Drory Y, Goldstein I, Jackson G, Kaul S, Kimmel SE, Kostis JB, Kloner RA, Lakin M, Meston CM: Management of sexual dysfunction in patients with cardiovascular disease: recommendations of the Princeton Consensus Panel. The American journal of cardiology 2000, 86(2):62-68. DOI: https://doi.org/10.1016/s0002-9149(00)00896-1. DOI: https://doi.org/10.1016/S0002-9149(00)01117-6
Smith KM, Romanelli F: Recreational use and misuse of phosphodiesterase 5 inhibitors. Journal of the American Pharmacists Association 2005, 45(1):63-75. DOI: https://doi.org/10.1331/1544345052843165 DOI: https://doi.org/10.1331/1544345052843165
Okutucu S, Aytemir K: Cinsel Gücü Artıran İlaçlar ve Kardiyovasküler Yan Etkileri.
Tunç L, Altunkan Ş, Biri H, Küpeli B, Alkibay T, Karaoğlan Ü, Bozkırlı İ: Effects of oral sildenafil citrate (Viagra) on heart rate variability. Gazi Medical Journal 2002, 13(3):117-121.
Bayraktar Z, İhsan A: Erektil disfonksiyonlu hastalarda hekim önerisi olmaksızın fosfodiesteraz-5 PDE5 inhibitörü kullanım oranı ve ilaç kullanım hataları. The New Journal of Urology, 6(2):26-31.
Croom KF, Curran MP: Sildenafil. Drugs 2008, 68(3):383-397. DOI: https://doi.org/10.2165/00003495-200868030-00009 DOI: https://doi.org/10.2165/00003495-200868030-00009
Network IPFCR: A controlled trial of sildenafil in advanced idiopathic pulmonary fibrosis. New England Journal of Medicine 2010, 363(7):620-628. DOI: https://doi.org/10.1056/NEJMoa1002110 DOI: https://doi.org/10.1056/NEJMoa1002110
Laties AM, Zrenner E: Viagra®(sildenafil citrate) and ophthalmology. Progress in retinal and eye research 2002, 21(5):485-506. DOI: https://doi.org/10.1016/S1350-9462(02)00013-7 DOI: https://doi.org/10.1016/S1350-9462(02)00013-7
Nagasawa S, Saka K, Yamagishi Y, Yajima D, Chiba F, Yamaguchi R, Torimitsu S, Iwase H: Association between sexual activity-related death and non-prescription use of phosphodiesterase type 5 inhibitors. Legal Medicine 2021, 48:101815. DOI: https://doi.org/10.1016/j.legalmed.2020.101815 DOI: https://doi.org/10.1016/j.legalmed.2020.101815
Özkara E, Üzün İ, Cantürk G, Tanç O, Cantürk N, Erkol Z: Ani ölüm olgularında sildenafil (Viagra) kullanımı. Adli Tıp Dergisi 2010, 24(1):22-29.
Toksöz UDS, Kızılkan Y, Peşkircioğlu L: Günlük (kronik) ve gerektikçe (on-demand) fosfodiesteraz tip-5 inhibitörü kullanımı. Androloji Bülteni, 15(52):7-11.
Kontaras K, Varnavas V, Kyriakides ZS: Does sildenafil cause myocardial infarction or sudden cardiac death? American Journal of Cardiovascular Drugs 2008, 8(1):1-7. DOI: https://doi.org/10.2165/00129784-200808010-00001. DOI: https://doi.org/10.2165/00129784-200808010-00001
Wysowski DK, Farinas E, Swartz L: Comparison of reported and expected deaths in sildenafil (Viagra) users. American Journal of Cardiology 2002, 89(11):1331-1334. DOI:https://doi.org/10.1016/S0002-9149(02)02342-1 DOI: https://doi.org/10.1016/S0002-9149(02)02342-1
Meth M, Chalmers R: Pulse Check: Trends in Drug Abuse January-June 2002 Reporting Period. Special Topic: A Look at Local Drug Markets. 2002.
Downie G, Hind C, Kettle J, Chick J: Drug and alcohol misuse The abuse and misuse of prescribed and over-the-counter medicines Psychiatric disorders associated with alcohol misuse. HOSPITAL PHARMACIST-LONDON- 2000, 7(9):242-254.
McLeod A, McKenna C, Northridge D: Myocardial infarction following the combined recreational use of viagra® and cannabis. Clinical Cardiology: An International Indexed and Peer‐Reviewed Journal for Advances in the Treatment of Cardiovascular Disease 2002, 25(3):133-134. DOI:https://doi.org/10.1002/clc.4960250310 DOI: https://doi.org/10.1002/clc.4960250310
Famularo G, Polchi S, Di Bona G, Manzara C: Acute aortic dissection after cocaine and sildenafil abuse. Journal of Emergency Medicine 2001, 21(1):78-79. DOI: https://doi.org/10.1016/S0736-4679(01)00345-6 DOI: https://doi.org/10.1016/S0736-4679(01)00345-6
Gresser U, Gleiter C: Erectile dysfunction: comparison of efficacy and side effects of the PDE-5 inhibitors sildenafil, vardenafil and tadalafil-review of the literature. European journal of medical research 2002, 7(10):435-446.
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