Acute kidney injury and critical limb ischaemia associated with the use of the so called “legal high” 3-fluorophenmetrazine

Fawzy, Michael Atef; Wong-Morrow, Wei San; Beaumont, A.C.; Farmer, Chris

doi:10.1007/s13730-017-0263-4

Cited by 6 publications

(4 citation statements)

References 3 publications

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“…Symptoms observed included tachycardia, reduced level of consciousness, agitation, delirium, dilated pupils, seizures, hypertension, respiratory depression and rhabdomyolysis 3. Another report from the UK involved a patient who used 3-FPM intravenously and required a period of renal replacement therapy and bilateral lower limb amputation following development of irreversible four-limb ischaemia 4. 3-FPM, in combination with the synthetic opioid U-47700 and several designer benzodiazepines, was found in the blood and urine of a 34-year-old man at autopsy 7…”

Section: Discussionmentioning

confidence: 99%

“…1 2 Up to 200 of these substances are designed every year, with the majority first making appearances in Europe 3. Given attempts by chemists to circumvent drug enforcement laws through slight alteration of parent compounds which are already illegal, in 2016 the UK banned all novel psychoactive substances 4. Nevertheless worldwide, these drugs are easily obtainable over the internet and present significant challenges to patient management in emergency and critical care settings 5…”

Section: Introductionmentioning

confidence: 99%

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Novel psychoactive substances: overdose of 3-fluorophenmetrazine (3-FPM) and etizolam in a 33-year-old man

Benesch¹,

Iqbal

2018

BMJ Case Reports

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Though illegal in the UK, in many countries novel psychoactive substances are quasi-legal synthetic compounds that are widely available online under the guise of research chemicals. These substances are relatively cheap and are often undetectable in standard drug screens. Nearly 200 such compounds are introduced yearly, and little is usually known about their metabolism or physiological effects. Consequently, managing patients in overdose situations on largely unknown substances usually involves supportive care, however anticipating and managing atypical side effects are challenging in the absence of knowledge of these compounds. In this report, we discuss our encounter with a 33-year-old unconscious man presenting with coingestion of a novel stimulant 3-fluorophenmetrazine with a rarely used benzodiazepine etizolam. This patient developed seizure-like activity and delayed widespread T-wave inversions, both of which ultimately resolved without sequelae.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Novel psychoactive substances: overdose of 3-fluorophenmetrazine (3-FPM) and etizolam in a 33-year-old man

Benesch¹,

Iqbal

2018

BMJ Case Reports

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“…The toxicity of 3-FPM has not been studied well at the moment of writing, although reports of severe adverse effects in human users have already been reported. It has been made a controlled substance in a few countries (Bäckberg, et al, 2016;Fawzy, et al, 2017;Mayer, et al, 2018).…”

Section: Stimulant Name Descriptionmentioning

confidence: 99%

Finding unknown stimulants applied in food supplements using Artificial Intelligence

Gavai¹,

Bouzembrak²,

Bulk³

et al. 2021

Preprint

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The world market for food supplements is large and is driven by the claims of these products to, for example, treat obesity, increase focus and alertness, decrease appetite, decrease the need for sleep or reduce impulsivity. The use of illegal compounds in food supplements is a continuous threat, certainly because these compounds and products have not been tested for safety by competent authorities. It is therefore of the utmost importance for the competent authorities to know when new products are being marketed and to warn users against potential health risks. In this study we present an approach to detect new and unknown stimulants in food supplements using machine learning. More than 20 new stimulants were identified from two different data sources, namely scientific literature applying word embedding on > 2 million abstracts and articles from formal and social media on the world wide web using text mining. The results show that the developed approach may be suitable to detect “unknowns” in the emerging risk identification activities performed by the competent authorities, which is currently a major hurdle.

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“…13 A published case report found an association between the intravenous use of 3-FPM and acute kidney injury and critical limb ischaemia. 14 3-FPM has also been detected in biological samples obtained from a multiple-drug fatality. 15 In addition, a 2016 study identified the main in vivo phase I and II metabolites of 3-FPM in human and rat urine, and reported on the microbial biotransformation products of 3-FPM.…”

Section: Introductionmentioning

confidence: 98%

Synthesis, analytical characterization, and monoamine transporter activity of the new psychoactive substance 4‐methylphenmetrazine (4‐MPM), with differentiation from its ortho‐ and meta‐ positional isomers

McLaughlin

Baumann

Kavanagh

et al. 2018

Drug Testing and Analysis

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The availability of new psychoactive substances (NPS) on the recreational drug market continues to create challenges for scientists in the forensic, clinical and toxicology fields. Phenmetrazine (3-methyl-2-phenylmorpholine) and an array of its analogs form a class of psychostimulants that are well documented in the patent and scientific literature. The present study reports on two phenmetrazine analogs that have been encountered on the NPS market following the introduction of 3-fluorophenmetrazine (3-FPM), namely 4-methylphenmetrazine (4-MPM), and 3-methylphenmetrazine (3-MPM). This study describes the syntheses, analytical characterization, and pharmacological evaluation of the positional isomers of MPM. Analytical characterizations employed various chromatographic, spectroscopic, and mass spectrometric platforms. Pharmacological studies were conducted to assess whether MPM isomers might display stimulant-like effects similar to the parent compound phenmetrazine. The isomers were tested for their ability to inhibit uptake or stimulate release of tritiated substrates at dopamine, norepinephrine and serotonin transporters using in vitro transporter assays in rat brain synaptosomes. The analytical characterization of three vendor samples revealed the presence of 4-MPM in two of the samples and 3-MPM in the third sample, which agreed with the product label. The pharmacological findings suggest that 2-MPM and 3-MPM will exhibit stimulant properties similar to the parent compound phenmetrazine, whereas 4-MPM may display entactogen properties more similar to 3,4-methylenedioxymethamphetamine (MDMA). The combination of test purchases, analytical characterization, targeted organic synthesis, and pharmacological evaluation of NPS and their isomers is an effective approach for the provision of data on these substances as they emerge in the marketplace.

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Acute kidney injury and critical limb ischaemia associated with the use of the so called “legal high” 3-fluorophenmetrazine

Cited by 6 publications

References 3 publications

Novel psychoactive substances: overdose of 3-fluorophenmetrazine (3-FPM) and etizolam in a 33-year-old man

Novel psychoactive substances: overdose of 3-fluorophenmetrazine (3-FPM) and etizolam in a 33-year-old man

Finding unknown stimulants applied in food supplements using Artificial Intelligence

Synthesis, analytical characterization, and monoamine transporter activity of the new psychoactive substance 4‐methylphenmetrazine (4‐MPM), with differentiation from its ortho‐ and meta‐ positional isomers

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