PMID- 21171849
OWN - NLM
STAT- MEDLINE
DCOM- 20110131
LR  - 20191210
IS  - 1556-9519 (Electronic)
IS  - 1556-3650 (Linking)
VI  - 48
IP  - 9
DP  - 2010 Nov
TI  - Case series of individuals with analytically confirmed acute mephedrone toxicity.
PG  - 924-7
LID - 10.3109/15563650.2010.531021 [doi]
AB  - CONTEXT: Previous reports of acute toxicity/harm associated with mephedrone use 
      have been based on self-reported mephedrone use; toxicological screening has not 
      been undertaken in these cases to determine whether mephedrone has been used. 
      OBJECTIVE: To report the first case series of analytically confirmed 
      mephedrone-related acute toxicity. MATERIALS AND METHODS: Serum samples were 
      collected from individuals presenting to an emergency department (ED) with acute 
      toxicity related to self-reported mephedrone use. Toxicological analysis, by 
      gas-chromatography coupled with mass-spectrometry and liquid chromatography with 
      tandem mass-spectrometry was performed to qualitatively confirm mephedrone use. 
      Symptoms/signs of acute mephedrone toxicity and basic physiological parameters 
      were extracted from the routine ED records. RESULTS: Acute mephedrone-related 
      toxicity was analytically confirmed in seven male patients; the mean +/- SD age was 
      24.6 +/- 6.5 years (range 16-36 years). Agitation (four patients) was the most 
      common symptom/sign reported; other common symptoms/signs included: palpitations 
      (two patients); chest pain (two patients); self-limiting pre-hospital seizures 
      (one patient) and headaches (one patient). The mean heart rate was 109.1 +/- 21.8 
      (range 80-140) beats per minute; one patient had a "severe" tachycardia (heart 
      rate of >/= 140 bpm). The mean systolic blood pressure was 153.0 +/- 39.6 (range 
      110-210) mmHg; three patients had clinically significant hypertension (systolic 
      blood pressure >/= 160 mmHg). DISCUSSION: These analytically confirmed acute 
      mephedrone toxicity presentations had clinical features of toxicity consistent 
      with an acute sympathomimetic toxidrome (e.g. hypertension, tachycardia and 
      agitation). These findings are similar to the pattern of toxicity seen with other 
      sympathomimetic recreational drugs such as 3,4-Methylenedioxymethamphetamine 
      (MDMA) and cocaine. CONCLUSION: The process for determining whether a novel 
      psychoactive substance should be controlled often relies on demonstrated/proven 
      acute harm associated with its use. It is important that clinical toxicologists 
      undertake appropriate biological sampling and toxicological analyses in suspected 
      cases of "novel psychoactive drug" toxicity. This will ensure that both 
      clinicians and legislative authorities are informed of the confirmed pattern of 
      toxicity associated with these drugs.
FAU - Wood, David M
AU  - Wood DM
AD  - Department of Clinical Toxicology, Guy's and St. Thomas' NHS Foundation Trust, 
      Guy's Hospital, Great Maze Pond, London, UK. David.Wood@gstt.nhs.uk
FAU - Davies, Susannah
AU  - Davies S
FAU - Greene, Shaun L
AU  - Greene SL
FAU - Button, Jenny
AU  - Button J
FAU - Holt, David W
AU  - Holt DW
FAU - Ramsey, John
AU  - Ramsey J
FAU - Dargan, Paul I
AU  - Dargan PI
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - England
TA  - Clin Toxicol (Phila)
JT  - Clinical toxicology (Philadelphia, Pa.)
JID - 101241654
RN  - 0 (Illicit Drugs)
RN  - 44RAL3456C (Methamphetamine)
RN  - 8BA8T27317 (mephedrone)
SB  - IM
MH  - Acute Disease
MH  - Adolescent
MH  - Adult
MH  - Chromatography, Liquid
MH  - Fatal Outcome
MH  - Female
MH  - Gas Chromatography-Mass Spectrometry
MH  - Humans
MH  - Illicit Drugs/*toxicity
MH  - Male
MH  - Methamphetamine/*analogs & derivatives/analysis/toxicity
MH  - Tandem Mass Spectrometry
MH  - Young Adult
EDAT- 2010/12/22 06:00
MHDA- 2011/02/01 06:00
CRDT- 2010/12/22 06:00
PHST- 2010/12/22 06:00 [entrez]
PHST- 2010/12/22 06:00 [pubmed]
PHST- 2011/02/01 06:00 [medline]
AID - 10.3109/15563650.2010.531021 [doi]
PST - ppublish
SO  - Clin Toxicol (Phila). 2010 Nov;48(9):924-7. doi: 10.3109/15563650.2010.531021.