Collapse, reported seizure—and an unexpected pill

Wood, David M.; Dargan, Paul I.; Button, Jennifer; Holt, David W.; Ovaska, Hanna; Ramsey, John; Jones, Alison L

doi:10.1016/s0140-6736(07)60674-6

Cited by 61 publications

(31 citation statements)

References 2 publications

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“…We have already reported that proactive ad hoc toxicological screening undertaken in recreational drug presentations, in which individuals self-report ingestion of novel drugs or have atypical presentations following ingestion of classical recreational drugs, can detect a range of novel or emerging recreational drugs [1][2][3][4][5]. This case also highlights that research chemical compounds, such as Bromo-dragonFLY, may also enter the recreational drug market.…”

Section: Discussionmentioning

confidence: 83%

“…In spite of this legislation, there have been many recent reports of toxicity associated with emerging "novel" recreational drugs or pharmaceutical agents misused as recreational drugs [1][2][3][4][5][6]. Often the legislation concerning these novel recreational drugs is inconsistent, with control only occurring in a limited number of countries [4].…”

Section: Introductionmentioning

confidence: 99%

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Delayed onset of seizures and toxicity associated with recreational use of Bromo-dragonFLY

et al. 2009

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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 4,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.

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Section: Discussionmentioning

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Delayed onset of seizures and toxicity associated with recreational use of Bromo-dragonFLY

et al. 2009

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“…We have already reported that proactive ad hoc toxicological screening undertaken in patients who present following the use of legal highs or in those with atypical presentations following ingestion of classical recreational drugs such as MDMA or amphetamines can detect novel recreational drugs such as glaucine, 2,5-dimethoxy-4-chloroamphetamine (DOC) and 1-benzylpiperazine [1][2][3]. Currently, in the majority of the cases of recreational drug toxicity, routine toxicological screening is not undertaken since real-time results that will alter the individual patient's clinical management are not routinely available.…”

Section: Discussionmentioning

confidence: 99%

“…Despite this legislation, there have been reports of toxicity associated with emerging novel recreational drugs or pharmaceutical agents misused as recreational drugs [1][2][3]. These drugs often are structurally very similar to controlled substances, thus result in similar clinical features.…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular toxicity associated with recreational use of diphenylprolinol (diphenyl-2-pyrrolidinemethanol [D2PM])

Lidder¹,

Dargan²,

Sexton

et al. 2008

J. Med. Toxicol.

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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 that are not covered under appropriate legislation, despite having similar chemical structures and/or clinical effects. In addition, these novel drugs are often sold legally on the street or through the Internet, with limited details of the exact contents, making application of the appropriate legislation difficult.Case Report: A male patient with no risk factors for ischemic heart disease, presented to our emergency department with agitation and chest pain characteristic of ischemia following the ingestion of two units of "Head Candy." He improved with oral diazepam over a period of 12 hours and there was no biochemical evidence of myocardial damage. Serum analysis demonstrated the presence of diphenylprolinol ) and glaucine at concentrations of 0.17 mg/L and 0.10 mg/L, respectively. No other recreational drugs were detected in an extensive toxicological screen of blood and urine samples.Discussion: This is the first reported case of confirmed toxicity associated with recreational use of diphenylprolinol in combination with glaucine. 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 recreational drugs.

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“…Por ello, para su diagnóstico, además de una adecuada y dirigida historia clínica toxicológica, es necesario un alto grado de sospecha basado en la aparición de un síndrome tóxico simpaticomimético 28 , y en su caso la determinación posterior cuantitativa mediante técnicas de cromatografía de gases y espectrometría de masas, en laboratorios toxicológicos de referencia 29 .…”

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Drogas emergentes (I): las «smart drugs»

Burillo-Putzé

Díaz

Pazos

et al. 2011

Anales Sis San Navarra

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resUMenEn los últimos años han ganado popularidad una serie de nuevas drogas, conocidas como smart drugs o legal highs, fácilmente accesibles a través de tiendas online. Ello ocurre sobre todo en los segmentos jóvenes de la población, asociado a su consumo lúdico fundamentalmente durante los fines de semana.En general son derivados sintéticos de productos naturales, de los que apenas existe investigación clíni-ca y que no son detectables en los laboratorios de los hospitales.Tres de estos productos, el BZP (1-benzilpiperacina), la mefedrona (4-metilcatinona) y el Spice son probablemente los más utilizados en Europa. Los dos primeros se consumen como alternativas al éxtasis y la cocaína, y se caracterizan por producir un cuadro clíni-co de tipo simpaticomimético, en ocasiones de consecuencias graves, con convulsiones e incluso muerte. El Spice (mezcla de hierbas con cannabinoides sintéticos como el JWH-018, el JWH-073 y el CP 47,497-C8) está ocasionando cuadros de dependencia y esquizofrenia.Aunque las drogas emergentes poseen un aura de seguridad, cada vez hay más experiencia sobre sus efectos secundarios.Palabras clave. Smart-drugs. Piperacinas. Catinonas. Mefedrona. Spice.

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Collapse, reported seizure—and an unexpected pill

Cited by 61 publications

References 2 publications

Delayed onset of seizures and toxicity associated with recreational use of Bromo-dragonFLY

Delayed onset of seizures and toxicity associated with recreational use of Bromo-dragonFLY

Cardiovascular toxicity associated with recreational use of diphenylprolinol (diphenyl-2-pyrrolidinemethanol [D2PM])

Drogas emergentes (I): las «smart drugs»

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