RESUMEN
BACKGROUND: Reports of intoxications with new psychoactive substances (NPS) mostly involve young people, as they are the main consumers of these types of drugs. This report centers on a case that was unusual due to it being a mass-poisoning event involving middle-aged individuals who had consumed a combination of the two different new psychoactive drugs 2,5-dimethoxy-4-ethylphenethylamine (2C-E) and 1-(8-bromofuro[2,3-f][1]benzofuran-4-yl)-2-propanamine (Bromo-DragonFly, BDF). CASE HISTORY: The mass poisoning of 29 individuals (24-56 years old) resulted in their admission to six different hospitals with severe symptoms of intoxication. All symptoms manifested after consumption of an unknown drug formulation around lunchtime during an esoteric weekend seminar. INVESTIGATION: Urine (n = 11) and blood samples (n = 29), collected from the 29 individuals for police investigation, were analyzed with immunochemical techniques, GC/MS and LC-MS/MS. 2C-E was confirmed in seven urine samples, but not in blood. BDF was confirmed in all urine samples, and in 17 blood samples. The blood samples exhibited BDF concentrations between ca. 0.6 and ca. 2.0 µg/L, while urine concentrations of BDF ranged from ca. 1.6 to 35 µg/L. The concentration of 2C-E in urine was found to be between ca. 1.5 and 183 µg/L. All patients made a complete recovery, although some had required mechanical ventilation. CONCLUSION: The investigation and the presentation of this case illustrates not only mass intoxication with 2C-E and BDF, with corresponding blood and urine concentrations, but also the necessity of collecting urine samples in cases where NPS-consumption is suspected, in order to improve the chances of analytical detection.
Asunto(s)
Anisoles/envenenamiento , Bromobenzoatos/envenenamiento , Drogas Ilícitas/envenenamiento , Propilaminas/envenenamiento , Psicotrópicos/envenenamiento , Sulfuros/envenenamiento , Adulto , Anisoles/análisis , Bromobenzoatos/análisis , Cromatografía Liquida , Femenino , Cromatografía de Gases y Espectrometría de Masas , Humanos , Drogas Ilícitas/análisis , Masculino , Persona de Mediana Edad , Estructura Molecular , Propilaminas/análisis , Psicotrópicos/análisis , Sulfuros/análisisRESUMEN
For the new psychoactive drug 5-(2-aminopropyl) benzofuran (5-APB), very limited knowledge is available regarding lethal concentrations. We present a case and report the post mortem blood concentration of a fatal outcome for a 25 year old man related to the consumption of 5-APB. After intake, he became unconscious and stopped breathing. Cardiopulmonary resuscitation was started without success. After 30min he was declared dead at the scene. During autopsy, whole blood from the femoral vein was collected and screened for a wide range of medicinal drugs and drugs of abuse. 5-APB was initially identified by ultra high performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UHPLC-QTOF-MS) and subsequently confirmed by using ultra high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS). The only toxicological findings were ethanol 0.6g/L, tetrahydrocannabinol (THC) 0.0024mg/L and 5-APB 0.86mg/L. The cause of death was attributed to intake of 5-APB. Only one previous report of a fatal 5-APB concentration as the main toxicological agent exist in the literature, and the present concentration indicated that 5-APB could be lethal in lower concentrations than previously reported.
Asunto(s)
Benzofuranos/sangre , Benzofuranos/envenenamiento , Drogas de Diseño/análisis , Drogas de Diseño/envenenamiento , Propilaminas/sangre , Propilaminas/envenenamiento , Adulto , Benzofuranos/química , Cromatografía Líquida de Alta Presión , Drogas de Diseño/química , Resultado Fatal , Humanos , Masculino , Espectrometría de Masas , Estructura Molecular , Propilaminas/química , Edema Pulmonar/patología , Trastornos Relacionados con Sustancias/complicacionesRESUMEN
INTRODUCTION: A multicenter retrospective survey of patients poisoned by herbicides containing glyphosate salts in Japan was conducted to identify differences in symptoms and outcome of poisoning. METHODS: Participants were patients who were transported to emergency facilities between October 2006 and March 2014 after consuming herbicides containing glyphosate potassium salt (GlyK(+)) (the K-group) or other glyphosate salts (the O-group). Questionnaires were mailed to 38 emergency facilities that agreed to participate in the study. RESULTS: Serum potassium levels upon arrival were significantly higher (p < 0.01), and abnormal electrocardiogram findings were significantly more common (p < 0.01) in the K-group (n = 55) than in the O-group (n = 62). Conversely, acute lung injury (ALI) including acute respiratory distress syndrome (ARDS) (p = 0.05) and liver injury (LI) (p < 0.01) were significantly more common during hospitalization in the O-group, although no significant differences in the duration of hospital stay (p = 0.92) or outcomes (p = 0.95) were observed between the two groups. DISCUSSION AND CONCLUSION: The ingestion of products containing glyphosate isopropylamine or ammonium salts, and polyoxyethyleneamine (POEA) as a surfactant, can cause severe organ injury. Physicians should note that the ingestion of products containing glyphosate potassium salt and surfactants other than POEA can cause hyperkalemia, potentially leading to fatal arrhythmias or cardiac arrest.
Asunto(s)
Glicina/análogos & derivados , Herbicidas/envenenamiento , Intoxicación/patología , Potasio/administración & dosificación , Lesión Pulmonar Aguda/inducido químicamente , Lesión Pulmonar Aguda/patología , Adulto , Anciano , Anciano de 80 o más Años , Enfermedad Hepática Inducida por Sustancias y Drogas/etiología , Enfermedad Hepática Inducida por Sustancias y Drogas/patología , Relación Dosis-Respuesta a Droga , Femenino , Glicina/administración & dosificación , Glicina/sangre , Glicina/envenenamiento , Herbicidas/administración & dosificación , Humanos , Japón , Masculino , Persona de Mediana Edad , Intoxicación/etiología , Polietilenglicoles/administración & dosificación , Polietilenglicoles/envenenamiento , Potasio/sangre , Propilaminas/administración & dosificación , Propilaminas/envenenamiento , Síndrome de Dificultad Respiratoria/inducido químicamente , Síndrome de Dificultad Respiratoria/patología , Estudios Retrospectivos , Tensoactivos/administración & dosificación , Tensoactivos/envenenamiento , Encuestas y Cuestionarios , Adulto Joven , GlifosatoRESUMEN
The emergence of a large number of new psychoactive substances (NPSs) in recent years poses a serious problem to clinical and forensic toxicologists. Here we report a patient who administrated ca. 500mg of 3-MMC (3-methyl-N-methylcathinone) and 400mg of 5-APB (5-(2-aminopropyl)benzofuran) in combination with 80g of ethyl alcohol. The clinical manifestations included agitation, seizures, hypertension, tachycardia, hyperthermia and bradycardia. The patient did not recover and died around 4h after the use of drugs. The cause of death was acute cardiovascular collapse that occurred following mixed intoxication with NPSs and alcohol. Toxicological analysis of post-mortem blood revealed 3-MMC and 5-APB in concentrations of 1.6µg/mL and 5.6µg/mL, respectively. Moreover, the serum alcohol concentration was 1.4g/L in ante-mortem sample collected 1h after admission to the hospital. This is the first report on blood concentration of 3-MMC and 5-APB in fatal intoxication.
Asunto(s)
Benzofuranos/envenenamiento , Estimulantes del Sistema Nervioso Central/envenenamiento , Drogas de Diseño/envenenamiento , Sobredosis de Droga , Metanfetamina/análogos & derivados , Propilaminas/envenenamiento , Consumo de Bebidas Alcohólicas/efectos adversos , Benzofuranos/sangre , Nivel de Alcohol en Sangre , Estimulantes del Sistema Nervioso Central/sangre , Drogas de Diseño/análisis , Toxicología Forense , Humanos , Masculino , Metanfetamina/sangre , Metanfetamina/envenenamiento , Propilaminas/sangre , Trastornos Relacionados con Sustancias/sangre , Adulto JovenRESUMEN
Two types of drugs are generally used for treating attention-deficit/hyperactivity disorder or attention-deficit disorder in humans: amphetamines or similar stimulants and the nonamphetamine atomoxetine. We describe the toxicity and treatment of both amphetamines and similar medications and atomoxetine in dogs and cats. Amphetamine intoxication can cause life-threatening stimulatory signs. Treatment is aimed at preventing absorption, controlling the stimulatory signs, and protecting the kidneys; prognosis is generally good. Atomoxetine also has a fast onset of action; stimulatory signs such as hyperactivity and tachycardia are often seen. There are little published data about treatment of atomoxetine toxicity in cats and dogs.
Asunto(s)
Inhibidores de Captación Adrenérgica/envenenamiento , Enfermedades de los Gatos/terapia , Estimulantes del Sistema Nervioso Central/envenenamiento , Enfermedades de los Perros/terapia , Inhibidores de Captación Adrenérgica/antagonistas & inhibidores , Anfetaminas/antagonistas & inhibidores , Anfetaminas/envenenamiento , Animales , Clorhidrato de Atomoxetina , Trastorno por Déficit de Atención con Hiperactividad/tratamiento farmacológico , Enfermedades de los Gatos/inducido químicamente , Enfermedades de los Gatos/diagnóstico , Gatos , Estimulantes del Sistema Nervioso Central/antagonistas & inhibidores , Enfermedades de los Perros/inducido químicamente , Enfermedades de los Perros/diagnóstico , Perros , Humanos , Centros de Control de Intoxicaciones/estadística & datos numéricos , Propilaminas/antagonistas & inhibidores , Propilaminas/envenenamientoRESUMEN
Bromo-Dragonfly (BDF) is a designer drug chemically related to LSD and amphetamine. The first registration in Denmark was in October 2007. In the present case an 18-year-old man ingested about 2 ml BDF and developed acute psychosis. At the hospital the patient displayed, hyperpyrexia, tachycardia, tachypnea and hypertension. Because of severe hallucinations and agitation the patient was detained at the hospital and received symptomatic treatment with large doses of benzodiazepines. Four days after hospitalization, the patient discharged himself without significant symptoms or paraclinical findings.
Asunto(s)
Bromobenzoatos/envenenamiento , Drogas de Diseño/envenenamiento , Propilaminas/envenenamiento , Psicosis Inducidas por Sustancias/etiología , Adolescente , Bromobenzoatos/química , Drogas de Diseño/química , Humanos , Masculino , Propilaminas/química , Psicosis Inducidas por Sustancias/diagnóstico , Psicosis Inducidas por Sustancias/tratamiento farmacológicoRESUMEN
INTRODUCTION: Many countries have specific legislation, such as the Controlled Substances Act (1970) in the United States and the Misuse of Drugs Act (1971) in the United Kingdom to control recreational drugs. There is a growing market and supply of "novel" recreational drugs, which include the misuse of pharmaceutical compounds and research chemicals. These are often not covered under current legislation, despite the fact that they often have both similar chemical structures and/or clinical effects to controlled recreational drugs. CASE REPORT: A male patient presented to an emergency department with delayed onset of severe agitation, hallucinations, and tonic-clonic seizures following the use of Bromo-dragonFLY and an unknown white powder. He settled following IV benzodiazepines and supportive care, and was discharged with no evidence of long-term sequelae. Analysis of the white powder by gas chromatography/mass spectrometry (GC/MS), ultraviolet/visible spectrophotometry (UV/VIS) and thin layer chromatography (TLC) showed the presence of Bromo-dragonFLY (1-(8-bromobenzo[1,2-b;4,5-b']difuran-4-yl)-2-aminopropane); serum analysis by GC/MS and liquid chromatography with tandem mass spectrometry (LC/MS/MS) confirmed that a combination of Bromo-dragonFLY (0.95 ng/mL), ketamine (20 ng/mL) and cannabis had been used by the patient. No other recreational drugs were detected in an extensive toxicological screen of serum and urine samples. DISCUSSION: This is the first confirmed case to be reported of toxicity with delayed onset of severe agitation, hallucinations and tonic-clonic seizures associated with recreational use of Bromo-dragonFLY (1-(8-bromobenzo[1,2-b;4,5-b']difuran-4-yl)-2-aminopropane) in combination with ketamine and cannabis. In our view, this case provides further support for the need for a systematic approach to toxicological screening of patients with recreational drug toxicity, to identify emerging drugs and provide evidence for legislative authorities to assist in revising the legal status of emerging recreational drugs.
Asunto(s)
Bromobenzoatos/envenenamiento , Epilepsia Tónico-Clónica/inducido químicamente , Drogas Ilícitas/envenenamiento , Propilaminas/envenenamiento , Adolescente , Benzodiazepinas/uso terapéutico , Cromatografía Liquida , Cromatografía en Capa Delgada , Cuidados Críticos , Epilepsia Tónico-Clónica/tratamiento farmacológico , Cromatografía de Gases y Espectrometría de Masas , Alucinaciones/inducido químicamente , Humanos , Ketamina/envenenamiento , Masculino , Fumar Marihuana/efectos adversos , Agitación Psicomotora/etiología , Espectrofotometría Ultravioleta , Detección de Abuso de Sustancias/métodos , Espectrometría de Masas en Tándem , Resultado del TratamientoRESUMEN
This paper reports a fatal overdose case involving the potent hallucinogenic drug Bromo-Dragonfly (1-(8-bromobenzo[1,2-b; 4,5-b']difuran-4-yl)-2-aminopropane). In the present case, an 18-year-old woman was found dead after ingestion of a hallucinogenic liquid. A medico-legal autopsy was performed on the deceased, during which liver, blood, urine and vitreous humour were submitted for toxicological examination. Bromo-Dragonfly was identified in the liver blood using UPLC-TOFMS, and was subsequently quantified in femoral blood (0.0047 mg/kg), urine (0.033 mg/kg) and vitreous humour (0.0005 mg/kg) using LC-MS/MS. Calibration standards were prepared from Bromo-Dragonfly isolated from a bottle found next to the deceased. The structure and purity of the isolated compound were unambiguously determined from analysis of UPLC-TOFMS, GC-MS, HPLC-DAD, (1)H and (13)C NMR data and by comparison to literature data. The autopsy findings were non-specific for acute poisoning. However, based on the toxicological findings, the cause of death was determined to be a fatal overdose of Bromo-Dragonfly, as no ethanol and no therapeutics or other drugs of abuse besides Bromo-Dragonfly were detected in the liver, blood or urine samples from the deceased. To our knowledge, this is the first report of quantification of Bromo-Dragonfly in a biological specimen from a deceased person. This case caused the drug to be classified as an illegal drug in Denmark on 5th December 2007.
Asunto(s)
Bromobenzoatos/envenenamiento , Alucinógenos/envenenamiento , Drogas Ilícitas/envenenamiento , Propilaminas/envenenamiento , Adolescente , Bromobenzoatos/análisis , Bromobenzoatos/química , Cromatografía Líquida de Alta Presión , Femenino , Toxicología Forense , Cromatografía de Gases y Espectrometría de Masas , Alucinógenos/análisis , Alucinógenos/química , Humanos , Drogas Ilícitas/análisis , Drogas Ilícitas/química , Estructura Molecular , Propilaminas/análisis , Propilaminas/química , Cuerpo Vítreo/químicaRESUMEN
Limited information exists on potentially adverse consequences following pediatric atomoxetine ingestions reported to poison control centers. Using pediatric atomoxetine ingestions reported to Texas poison control centers during 2003-2005, the proportion of cases involving serious outcomes (medical outcomes classified as moderate effects, major effects, death, or judged as potentially toxic exposures) was determined for selected variables and evaluated for statistical significance by calculating the rate ratio (RR) and 95% confidence interval (CI). Of 501 cases identified, 31 (6%) involved serious outcomes. Higher serious outcome rates were found with a maximum dose of >2.8 mg/kg or >200 mg or >4 tablets. Serious outcome rates were also higher if the exposure involved intentional self-harm or the patient was already at or en route to a health care facility when the poison control center was contacted or referred to a health care facility by the poison control center. The severity of the outcome associated with pediatric atomoxetine ingestions was dependent upon the dose and the circumstances of the ingestion (whether intentional self-harm was involved). The management of patients with serious outcomes was more likely to involve health care facilities. This information is useful for creating triage guidelines for the management of pediatric atomoxetine ingestions.
Asunto(s)
Inhibidores de Captación Adrenérgica/envenenamiento , Centros de Control de Intoxicaciones/estadística & datos numéricos , Propilaminas/envenenamiento , Adolescente , Adulto , Clorhidrato de Atomoxetina , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Intento de Suicidio , TexasRESUMEN
BACKGROUND: Atomoxetine (Strattera), has recently been approved for the treatment of Attention Deficit Hyperactivity Disorder (ADHD) in adolescents and adults. Atomoxetine acts by inhibiting the reuptake of norepinephrine. There are limited reports of the effects of atomoxetine in overdose. We report a case of isolated atomoxetine overdose resulting in seizure and mild cardiac toxicity. CASE REPORT: A 17-year-old female ingested 2840 mg of atomoxetine in an attempt to kill herself. She presented to an Emergency Department 2-3 hours after ingestion and soon after arrival had a tonic clonic seizure that lasted one minute. An initial electrocardiogram (ECG) revealed a sinus tachycardia with a rate of 110 beats per minute (bpm) and a QRS interval of 93 ms. She was transferred to a pediatric toxicology referral center and had progressive improvement in her symptoms. Gas chromatography and mass spectometry of the urine detected the following drugs: atomoxetine, naproxen, and nicotine. A quantitative serum atomoxetine level of 1995 ng/ml and a quantitative serum naproxen level of 12 mcg/L (30-90 mcg/L anti-inflammatory or analgesic range) were obtained. The patient had no further complications and was without symptoms within 24 hours of hospitalization. Repeat ECG 14 hours following ingestion revealed QRS interval of 79 ms. CONCLUSION: We report a case of atomoxetine overdose resulting in seizure and mild widening of the QRS interval on ECG. It is important to be aware of the potential for atomoxetine to cause central nervous system and cardiac toxicity.
Asunto(s)
Inhibidores de Captación Adrenérgica/envenenamiento , Propilaminas/envenenamiento , Convulsiones/inducido químicamente , Adolescente , Inhibidores de Captación Adrenérgica/sangre , Clorhidrato de Atomoxetina , Sobredosis de Droga , Femenino , Humanos , Propilaminas/sangre , Intento de Suicidio , Taquicardia Sinusal/inducido químicamenteRESUMEN
Atomoxetine is a recently approved medication for attention deficit disorder. It is a selective norepinephrine reuptake inhibitor with an onset of action within 2 h, and a duration of effect up to 40 h in therapeutic doses. Experience in the overdose setting is limited. After brief training in systematic chart review, reviewers blinded to the purpose of the study completed a standardized data collection sheet. Two years after atomoxetine was released, poison center patient encounters were reviewed. Age, outcomes, and signs and symptoms were recorded. All patients were followed until the cessation of symptoms or 24 h. Seventeen cases of isolated atomoxetine were reviewed. The age range of these 6 patients was 9 months to 28 years old with a mean of 15.6 years. The range of amount ingested was 10-1200 mg. The onset of symptoms was delayed as long as 3 h in 3 patients. All neurological symptoms were preceded by tachycardia. Ten of 17 patients had tachycardia, 6/17 had emesis, and 3/17 had agitation that required benzodiazepines to control. All symptoms resolved within 30 h. Supratherapeutic ingestions of atomoxetine can result in transient tachycardia, vomiting, and cognitive disturbances.
Asunto(s)
Inhibidores de Captación Adrenérgica/envenenamiento , Propilaminas/envenenamiento , Adolescente , Adulto , Clorhidrato de Atomoxetina , Trastorno por Déficit de Atención con Hiperactividad/tratamiento farmacológico , Niño , Preescolar , Trastornos del Conocimiento/inducido químicamente , Sobredosis de Droga/patología , Humanos , Lactante , Centros de Control de Intoxicaciones/estadística & datos numéricos , Estudios Retrospectivos , Taquicardia/inducido químicamente , Vómitos/inducido químicamenteRESUMEN
BACKGROUND: Atomoxetine uses a novel non-stimulant approach to the treatment of attention deficit hyperactivity disorder. There is limited information on overdose of atomoxetine in children or adults. OBJECTIVE: To provide information on atomoxetine in overdose. METHODS: Case series were conducted at 3 regional poison centers for atomoxetine ingestion in children (age < or = 17 y). Exclusion criteria were polypharmacy or lack of follow-up. RESULTS: Forty patients were included (25 boys; 63%) in the study. The mean +/- SD age was 6.1 +/- 4.9 years (range 9 mo-17 y). Twenty-five patients were managed at home, 14 in hospital emergency departments (3 children were admitted), and 1 patient was managed in a physician's office. Symptoms reported were tachycardia, drowsiness, nausea, hypertension, and vomiting. A seizure was reported in one child who had recently started atomoxetine therapy. No arrhythmias beyond sinus tachycardia were reported. Mean maximum heart rate in patients with tachycardia was 131 +/- 14 beats/min. The mean dose ingested, categorized by medical outcome, was: no effect (n = 22), 40 +/- 32 mg; minor effect (n = 14), 167 +/- 221 mg; and moderate effect (n = 4), 249 +/- 326 mg. There were no major outcomes or fatalities. The lowest dose ingested that resulted in hypertension was 480 mg, in a 14-year-old girl (BP 136/95 mm Hg). CONCLUSIONS: In this case series, clinically significant cardiovascular effects requiring direct intervention did not occur. Activated charcoal and/or observation appear to be sufficient for accidental ingestion. Further investigation may be needed to indicate whether seizures occur from atomoxetine ingestion.
Asunto(s)
Centros de Control de Intoxicaciones/estadística & datos numéricos , Propilaminas/envenenamiento , Adolescente , Clorhidrato de Atomoxetina , Carbón Orgánico/administración & dosificación , Carbón Orgánico/uso terapéutico , Niño , Preescolar , Relación Dosis-Respuesta a Droga , Tratamiento de Urgencia/métodos , Tratamiento de Urgencia/estadística & datos numéricos , Femenino , Humanos , Hipertensión/inducido químicamente , Lactante , Masculino , Propilaminas/administración & dosificación , Convulsiones/inducido químicamente , Autoadministración/estadística & datos numéricos , Intento de Suicidio/estadística & datos numéricos , Taquicardia/inducido químicamenteAsunto(s)
Intoxicación/diagnóstico , Intoxicación/terapia , Psicotrópicos/efectos adversos , Adolescente , Anticonvulsivantes/uso terapéutico , Clorhidrato de Atomoxetina , Trastorno por Déficit de Atención con Hiperactividad/tratamiento farmacológico , Niño , Muerte Súbita/etiología , Trastorno Depresivo/tratamiento farmacológico , Humanos , Propilaminas/efectos adversos , Propilaminas/envenenamiento , Psicotrópicos/envenenamiento , Intento de Suicidio , Ácido Valproico/uso terapéuticoRESUMEN
Propylhexedrine is a potent alpha-adrenergic drug available as a nasal decongestant, which drug abusers sometimes extract and inject into a central vein. A 25-year-old white male presented to a local emergency department 32 h after attempting to inject his right internal jugular vein with "home-made crank." Following injection, he noted right neck pain, followed by fever and chills. On emergency department admission, he had inspiratory stridor and respiratory distress. Massive edema of his right neck extended from his anterior chest to the right parotid. Neck radiographs showed extensive paracervical swelling with displacement of the trachea. The patient was taken to surgery for nasotracheal intubation with fiberoptic guidance and surgical exploration. The neck contained extensive necrotic tissue that was surgically debrided. In spite of treatment with antibiotics, he developed progressive renal failure and hypotension unresponsive to fluid therapy, followed by cardiopulmonary arrest and death.
Asunto(s)
Descongestionantes Nasales/envenenamiento , Propilaminas/envenenamiento , Enfermedades Respiratorias/inducido químicamente , Adulto , Sobredosis de Droga , Resultado Fatal , Humanos , Inyecciones Intravenosas , Venas Yugulares , Masculino , Descongestionantes Nasales/administración & dosificación , Propilaminas/administración & dosificaciónRESUMEN
Chemical-toxicological analysis of blood and tissue samples from a drug-dependent person which had been found dead revealed the presence of propylhexedrine. The blood concentration was estimated to be 3.75 mg/l, this value may explain a fatal intoxication. However, death was obviously due to massive blood aspiration from nasal bleeding.
Asunto(s)
Muerte Súbita/patología , Propilaminas/envenenamiento , Trastornos Relacionados con Sustancias/patología , Adulto , Causas de Muerte , Sobredosis de Droga/patología , Hemorragia/patología , Humanos , Pulmón/patología , Masculino , Enfermedades Nasales/patología , Neumonía por Aspiración/patologíaAsunto(s)
Propilaminas/envenenamiento , Trastornos Relacionados con Sustancias , Adulto , Acatisia Inducida por Medicamentos , Humanos , Hipertensión/inducido químicamente , Masculino , Medicamentos sin Prescripción/farmacología , Medicamentos sin Prescripción/envenenamiento , Propilaminas/farmacología , Relación Estructura-Actividad , Taquicardia/inducido químicamente , Temblor/inducido químicamenteAsunto(s)
Propilaminas/envenenamiento , Administración Oral , Adolescente , Adulto , Femenino , Humanos , Masculino , Propilaminas/análisis , Distribución TisularRESUMEN
Isoaminile (Peracon) has found in Italy a certain success as a substitute for hard narcotcis. Three observations are reported in which five young adults have been intoxicated by the i.v. administration of the cough suppressant. On the basis of two opposed points of view suggested by the Literature to explain the compulsive abuse of this drug, the A. have studied its physical dependence capacity by using an original technique. The isoaminile cyanide release has been measured too. The experimental results demonstrate that isoaminile does not determine a physical dependence; a slight CN- release activity occurs in vivo only with high doses.
Asunto(s)
Acetonitrilos/envenenamiento , Antitusígenos/envenenamiento , Adulto , Cianuros/metabolismo , Femenino , Humanos , Riñón/metabolismo , Hígado/metabolismo , Masculino , Naloxona/farmacología , Propilaminas/envenenamiento , Tiempo de Reacción/efectos de los fármacos , Trastornos Relacionados con SustanciasRESUMEN
Propylhexedrine was implicated in 15 deaths investigated by the Dallas County Medical Examiner since 1973. Twelve of the deaths were attributable to intravenous abuse of the contents of the Benzedrex® inhaler. Each death could be defined as sudden. Pulmonary edema, foreign body granulomas, fibrosis and evidence of pulmonary hypertension were frequent postmortem findings. Right ventricular hypertrophy was present in nine of the 12 subjects who died of intravenous propylhexedrine abuse. Two homicides and one suicide were propylhexedrine-related. Intravenous propylhexedrine abuse should be considered in the differential diagnosis of right ventricular hypertrophy and/or pulmonary hypertension, and it should be suspected in cases of sudden death involving young adults displaying evidence of intravenous drug abuse.