|Titre :||Recreational use of mephedrone (4-methylmethcathinone, 4-MMC) with associated sympathomimetic toxicity (2010)|
|Auteurs :||D. M. WOOD ; S. DAVIES ; M. PUCHNAREWICZ ; J. BUTTON ; R. ARCHER ; H. OVASKA ; J. RAMSEY ; T. LEE ; D. W. HOLT ; P. I. DARGAN|
|Type de document :||Article : Périodique|
|Dans :||Journal of Medical Toxicology (Vol.6, n°3, September 2010)|
|Article en page(s) :||327-330|
|Discipline :||PRO (Produits, mode d'action, méthode de dépistage / Substances, action mode, screening methods)|
Thésaurus TOXIBASEETUDE DE CAS ; INTOXICATION ; MEPHEDRONE ; USAGE RECREATIF ; TOXICITE ; EFFET SECONDAIRE ; SYMPTOME ; TOXICOLOGIE ; DROGUES DE SYNTHESE ; DEPISTAGE
INTRODUCTION: Cathinone is a pharmacologically active alkaloid that can be extracted from the leaves of the khat plant (Catha edulis). There are synthetic derivatives of cathinone entering the recreational drug market, including mephedrone (4-methylmethcathinone, 4-MMC). There are discrepancies in the legal status of both the khat plant and its extracted alkaloids between the UK and the USA.
CASE REPORT: A 22-year-old man purchased 4 g of mephedrone powder over the Internet from a chemical supplier based in China. He initially ingested 200 mg of the mephedrone orally, with no perceived clinical effects, and thereafter injected the remaining 3.8 g intramuscularly into his thighs. Shortly after the injection, he developed palpitations, "blurred tunnel vision," chest pressure, and sweating and felt generally unwell; he presented to hospital with continuing features of sympathomimetic toxicity. His symptoms settled over the next 4 h after a single dose of oral lorazepam. Qualitative analysis of the urine and serum sample was undertaken using gas chromatography with mass spectrometric (GC/MS) detection, both positive for the presence of 4-methylmethcathinone. Quantitative analysis of the serum sample was undertaken by liquid chromatography with tandem mass spectrometric detection; the estimated mephedrone concentration was 0.15 mg/l. Routine toxicological analysis of the serum and urine specimens using a broad GC/MS toxicology screen did not detect any other drugs or alcohol.
DISCUSSION: This is the first case of isolated 4-MMC toxicity, with confirmatory analytical findings. It is important that clinical toxicologists and emergency physicians work together to ensure a better understanding of the toxicity of novel/emerging drugs such as 4-MMC.
|Domaine :||Drogues illicites / Illicit drugs|
|Sous-type de document :||Etude de cas / Case report|
|Refs biblio. :||26|
|Affiliation :||Clinical Toxicology, Guy's and St. Thomas' NHS Foundation Trust and King's Health Partners, London, UK|