Fatal intoxication of a regular drug user following N-ethyl-hexedrone and ADB-FUBINACA consumption

Kovács, Katalin; Kereszty, Éva; Berkecz, Róbert; Tiszlavicz, László; Sija, Éva; Körmöczi, Tímea; Jenei, Nikolett; Révész-Schmehl, Hajnal; Institóris, László

doi:10.1016/j.jflm.2019.04.012

Cited by 32 publications

(18 citation statements)

References 20 publications

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“…Adamowicz et al [16] described the case of the death of an 18-year-old male addicted to drugs and NPS; apart from N-ethylhexedrone (1351 ng/mL in urine, 34 ng/mL in bile, 3 ng/mL in bloody fluid from the lung, and 5 ng/g in tissue homogenate from brain), the following drugs were found: 4-CMC (1477 ng/mL in urine, and 41 ng/mL in bile), α-PiHP, benzoylecgonine, and MDMA. Kovács et al [15] described fatal intoxication with a combination of N-ethylhexedrone and ADB-FUBINACA; the concentration in the blood of N-ethylhexedrone was 285 ng/mL, while the concentration of ADB-FUBINACA was 0.08 ng/ mL. Dunlop et al [33] discussed acute toxicity related to the use by a 56-year-old man of 3-hydroxyphencyclidine and N-ethylhexedrone.…”

Section: Discussionmentioning

confidence: 99%

“…According to the European Drug Report 2018 [14] in 2016, 4-CMC was the second most frequently confiscated cathinone in Europe and the one seized in the largest amounts (890 kg). The literature contains cases of deaths related to the use of synthetic cathinones, individually or in combination with substances from other groups [7,[15][16][17][18][19][20].…”

Section: Introductionmentioning

confidence: 99%

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Fatal intoxication with U-47700 in combination with other NPS (N-ethylhexedrone, adinazolam, 4-CIC, 4-CMC) confirmed by identification and quantification in autopsy specimens and evidences

2021

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Purpose We present a case of fatal intoxication with U-47700 in combination with other NPS (N-ethylhexedrone, adinazolam, 4-chloro-N-isopropylcathinone (4-CIC), 4-chloromethcathinone (4-CMC) and sertraline) confirmed by identification and quantification in biological materials and evidences found at the scene in 2017 in Poland. Methods Blood and urine samples were extracted with ethyl acetate from alkaline medium (pH 9); powders/crystals were diluted with methanol. The analysis was carried out using ultra-high-performance liquid chromatography–tandem mass spectrometry. Validation criteria were evaluated for blood and urine at the concentrations of 10 and 100 ng/mL. Results The validation parameters of the method were within acceptable ranges. In the presented case, the determined concentrations of drugs were as follows, in blood: U-47700, 1470 ng/mL; N-ethylhexedrone, 58 ng/mL; adinazolam, 18 ng/mL; 4-CIC, 8.0 ng/mL; 4-CMC, 1.7 ng/mL; in urine: U-47700, 3940 ng/mL; N-ethylhexedrone, 147 ng/mL; adinazolam, 82 ng/mL; 4-CIC, 130 ng/mL; 4-CMC, 417 ng/mL. Sertraline (blood, 89 ng/mL; urine, 32 ng/mL) was also determined in both materials. The same substances were also found in 5 powders/crystals: U-47700 (12% by weight), N-ethylhexedrone (54%), adinazolam (14%), 4-CIC (23%), 4-CMC (26%). After 775 days of storage, biological samples at + 4 °C, the most stable substance was sertraline and the less, synthetic cathinones, especially 4-CIC and 4-CMC. Conclusions The described case of fatal intoxication with NPS presented postmortem concentrations of U-47700, 4-CMC, N-ethylhexedrone, adinazolam and 4-CIC for the first time in the literature. The paper also showed stability study of these substances stored at + 4 °C for 775 days.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Fatal intoxication with U-47700 in combination with other NPS (N-ethylhexedrone, adinazolam, 4-CIC, 4-CMC) confirmed by identification and quantification in autopsy specimens and evidences

2021

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“…Symptoms may persist for 24-48 h in 45% of cases, and neurological and cardiovascular symptoms can be long-lasting. There have been several reports of serious toxicity associated with synthetic cathinones, including many fatalities in EU, USA, and Japan: cardiac ischemia and heart failure can be the most plausible cause of death [5,[78][79][80]. Cardiac toxicity and death have been reported also to be related to the triggering effect of synthetic cathinones on torsade de pointes due to QT prolongation [81].…”

Section: Synthetic Cathinones (B-keto Amphetamines)mentioning

confidence: 99%

New Drugs of Abuse and Cardiovascular Function

Locatelli¹,

Lonati²,

Petrolini³

2020

Brain and Heart Dynamics

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Over the past decade, several new chemical compounds (the so-called NPS, new or novel psychoactive substances) have been synthesized and placed on the abuse market. About a thousand agents are known and monitored by supranational and national agencies because they cause new intoxication, prolonged health adverse effects, and addiction. Synthetic cannabinoids, cathinones, ketamines, new phenethylamines, and other molecules are today readily available at low cost. The high potency of these compounds, the important effects on the cardiovascular and central nervous systems, the still little knowledge about the prolonged health consequences, together with the hope to identify contrastable mechanisms of toxicity, have conquered

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“…Depending on the route of administration and the tolerance of the user, the dose of NEH resulting in the desired effects ranges from 10 to 250 mg. In addition, depending on the route of admission, NEH effects appear within 2 or 20–25 min after intranasal or oral administration, respectively ( 1 , 5 ).…”

Section: Introductionmentioning

confidence: 99%

“…Only a few toxicological case reports on NEH have been published so far. Authors have reported non-fatal mixed intoxication, driving under the influence and—in fatalities—included traffic accidents and overdose in which both psychoactive substances and health conditions were co-factors in the fatal outcome ( 1 , 5 , 6 ). Moreover, in studies available in the scientific literature, there are no procedures describing the quantification of NEH by liquid chromatography-triple quadrupole-mass spectrometry (LC–MS-MS).…”

Section: Introductionmentioning

confidence: 99%

Fatal N-Ethylhexedrone Intoxication

Domagalska

Banaszkiewicz

Woźniak

et al. 2020

Journal of Analytical Toxicology

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N-Ethylhexedrone [2-(ethyloamino)-1-phenylhexan-1-one; α-ethylaminohexanophenone; NEH] is one of the most recent synthetic cathinones that appeared on the illegal market in late 2015. The majority of information concerning the model of consumption of NEH and its impact on the body originates only from self-reports from grey literature websites and drug forums. There are only limited data associated with the concentrations of NEH in blood samples available in the literature. This article presents a case of fatal NEH intoxication and a method for the determination of this substance in whole blood. A 21-year-old man without any diagnosed diseases was admitted to the hospital due to disorientation, aggression and finally loss of consciousness. Hyperthermia (>41°C), tachycardia (>160 beats per minute), tachypnoe (20 breaths per minute), blood pressure (110/60 mmHg) and acute kidney failure were diagnosed. After a few hours of hospitalization, the patient died. A plastic bag with a white powder was found in his underwear. Analysis of the powder by another laboratory revealed cocaine hydrochloride; however, no cocaine or its metabolites were found in the biological material upon testing in our laboratory. Therefore, re-analysis of the powder was performed, and NEH was identified. Liquid-liquid extraction followed by LC–MS-MS analysis were used for the determination of NEH in blood. The validation parameters were as follows: calibration range 1–250 ng/mL, accuracy 106.5–109.9%, precision 3.5–6.3%, recovery 90.1–96.9%, LOD 0.07 ng/mL and LOQ 1 ng/mL. NEH was quantified in the blood at a concentration of 145 ng/mL. Additionally, amphetamine at low concentrations and THC-COOH were detected. Our study provided information on the possible lethal concentration and toxidrome that clinicians can observe for NEH-intoxicated patients and can be helpful during the preparation of toxicology analysis reports for a court of law for proper data interpretation.

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Fatal intoxication of a regular drug user following N-ethyl-hexedrone and ADB-FUBINACA consumption

Cited by 32 publications

References 20 publications

Fatal intoxication with U-47700 in combination with other NPS (N-ethylhexedrone, adinazolam, 4-CIC, 4-CMC) confirmed by identification and quantification in autopsy specimens and evidences

Fatal intoxication with U-47700 in combination with other NPS (N-ethylhexedrone, adinazolam, 4-CIC, 4-CMC) confirmed by identification and quantification in autopsy specimens and evidences

New Drugs of Abuse and Cardiovascular Function

Fatal N-Ethylhexedrone Intoxication

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