Titre : | A case of 3,4-dimethoxyamphetamine (3,4-DMA) and 3,4-methylenedioxymethamphetamine (MDMA) toxicity with possible metabolic interaction (2016) |
Auteurs : | M. A. DARRACQ ; S. L. THORNTON ; A. B. MINNS ; R. R. GERONA |
Type de document : | Article : Périodique |
Dans : | Journal of Psychoactive Drugs (Vol.48, n°5, November-December 2016) |
Article en page(s) : | 351-354 |
Langues: | Anglais |
Discipline : | PRO (Produits, mode d'action, méthode de dépistage / Substances, action mode, screening methods) |
Mots-clés : |
Thésaurus géographique ETATS-UNISThésaurus mots-clés ETUDE DE CAS ; MDMA-ECSTASY ; TOXICITE ; ANALYSE CHIMIQUE ; PHARMACOCINETIQUE ; METABOLISME ; PHARMACOLOGIE |
Résumé : |
Background: We present a case of "ecstasy" ingestion revealing 3,4-methylenedioxymethamphetamine (MDMA) and 3,4-dimethoxyamphetamine (3,4-DMA) and absence of cytochrome P450 (CYP)-2D6 MDMA metabolites.
Case report: A 19-year-old presented following a seizure. Initial vital signs were normal. Laboratories were normal with the exception of sodium 127 mEq/L and urine drugs of abuse screen positive for amphetamines. Twelve hours later, serum sodium was 114 mEq/L and a second seizure occurred. After receiving hypertonic saline (3%), the patient had improvement in mental status and admitted to taking "ecstasy" at a rave prior to her initial presentation. Liquid chromatography-time-of-flight mass spectrometry (LC-TOF/MS) of serum and urine revealed MDMA, 3,4-DMA, and the CYP-2B6 MDMA metabolites 3,4-methylendioxyamphetamine (MDA) and 4-hydroxy-3-methoxyamphetamine (HMA). The CYP2D6 metabolites of MDMA, 3,4-dihydromethamphetamine (HHMA) and 4-hydroxy-3-methoxymethamphetamine (HMMA), were detected at very low levels. Conclusion: This case high-lights the polypharmacy which may exist among users of psychoactive illicit substances and demonstrates that concurrent use of MDMA and 3,4-DMA may predispose patients to severe toxicity. Toxicologists and other healthcare providers should be aware of this potential toxicity. |
Domaine : | Drogues illicites / Illicit drugs |
Sous-type de document : | Etude de cas / Case report |
Affiliation : | Fresno Medical Education Program, Department of Emergency Medicine, Division of Medical Toxicology, University of California San Francisco, Fresno, CA, USA |
Cote : | Abonnement |
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