PMID- 3285124
OWN - NLM
STAT- MEDLINE
DCOM- 19880616
LR  - 20191210
IS  - 0113-5244 (Print)
IS  - 0113-5244 (Linking)
VI  - 3
IP  - 1
DP  - 1988 Jan-Dec
TI  - 'Designer drugs'. A problem in clinical toxicology.
PG  - 1-17
AB  - 'Designer drugs' are substances intended for recreational use which are 
      derivatives of approved drugs so as to circumvent existing legal restrictions. 
      The term as popularised by the lay press lacks precision. Contrary to the popular 
      belief that 'designer drugs' are original creations, the majority of these agents 
      are 'borrowed' from legitimate pharmaceutical research. They merely represent the 
      most recent developments in the evolution of mind-altering chemicals. The most 
      extensively studied class of psychoactive compounds is the phenylethylamines 
      (mescaline analogues). This class includes catecholamines, therapeutic agents and 
      numerous illicit derivatives. Subtle alterations of the phenylethylamine molecule 
      give rise to a spectrum of pharmacological properties ranging from pure 
      sympathomimetic stimulation to primarily psychoactive effects. Although most of 
      these compounds are only of historical interest, amphetamine, methamphetamine, 
      3,4-methylenedioxyamphetamine (MDA), and 3,4-methylenedioxymethamphetamine (MDMA) 
      continue to be used recreationally. Many deaths have been ascribed to this class 
      of compounds. In overdose the differences between these compounds blur and the 
      clinical presentation is similar to that of amphetamine overdose characterised by 
      tachycardia, hypertension, hyperthermia, diaphoresis, mydriasis, agitation, 
      muscle rigidity, and hyper-reflexia. Death usually results from arrhythmias, 
      hyperthermia or intracerebral haemorrhage. Treatment is aggressive and supportive 
      with careful attention to temperature, blood pressure and seizure control. 
      Synthetic opioid derivatives, which represent the second major class of 'designer 
      drugs', are derivatives of fentanyl (e.g. alpha-methylfentanyl, 3-methylfentanyl) 
      or pethidine (meperidine) and are extremely potent compounds responsible for 
      numerous overdose deaths. Attempts to synthesise pethidine have resulted in the 
      accidental production of MPTP (1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine), a 
      compound which is metabolised in the brain by the monoamine oxidase system to a 
      toxic intermediate (MPP+) which selectively destroys the sustantia nigra, 
      resulting in the rapid onset of severe Parkinsonian symptoms. Naloxone will 
      antagonise the opiate effects of this drug class, although high doses may be 
      required. Arylhexylamines constitute the third class of 'designer drugs'. The 
      predominant member of this class is phencyclidine (PCP), a derivative of the 
      anaesthetic ketamine. This unique class of psychoactive agents exhibits broad and 
      complex pharmacological effects.(ABSTRACT TRUNCATED AT 400 WORDS)
FAU - Buchanan, J F
AU  - Buchanan JF
AD  - San Francisco Regional Poison Control Center, San Francisco General Hospital, 
      University of California.
FAU - Brown, C R
AU  - Brown CR
LA  - eng
GR  - GM 07546/GM/NIGMS NIH HHS/United States
PT  - Journal Article
PT  - Research Support, U.S. Gov't, P.H.S.
PT  - Review
PL  - New Zealand
TA  - Med Toxicol Adverse Drug Exp
JT  - Medical toxicology and adverse drug experience
JID - 8709214
RN  - 0 (Illicit Drugs)
SB  - IM
MH  - Chemistry, Pharmaceutical
MH  - Humans
MH  - Illicit Drugs/*adverse effects
MH  - Legislation, Drug/trends
RF  - 65
EDAT- 1988/01/01 00:00
MHDA- 1988/01/01 00:01
CRDT- 1988/01/01 00:00
PHST- 1988/01/01 00:00 [pubmed]
PHST- 1988/01/01 00:01 [medline]
PHST- 1988/01/01 00:00 [entrez]
AID - 10.1007/BF03259928 [doi]
PST - ppublish
SO  - Med Toxicol Adverse Drug Exp. 1988 Jan-Dec;3(1):1-17. doi: 10.1007/BF03259928.