Liquid Chromatography–High-Resolution Mass Spectrometry (LC–HRMS) Analysis Following Voluntary Carvedilol Poisoning in a Subject with Cirrhosis: A Case Report.

The article focuses on a case study of carvedilol intoxication following a suicide attempt involving a large dose (75 mg) of immediate-release carvedilol combined with alcohol in a patient with liver cirrhosis. Carvedilol, a beta blocker used to treat hypertension, showed an unusually high plasma concentration of 906 µg/L three hours post-ingestion, the highest reported to date, likely due to impaired hepatic metabolism associated with cirrhosis. Pharmacokinetic analysis using liquid chromatography–high-resolution mass spectrometry (LC–HRMS) indicated a one-compartment, first-order elimination model with a half-life of 5.8 hours, consistent with known carvedilol kinetics in hepatic impairment. The study highlights the importance of monitoring carvedilol plasma levels in intoxication cases, especially in patients with liver dysfunction, while noting that carvedilol poisoning is rare and generally not severe when treated promptly with glucagon.