Kratom alkaloids and O-desmethyltramadol in urine of a "Krypton" herbal mixture consumer
Kratom alkaloids and O-desmethyltramadol in urine of a "Krypton" herbal mixture consumer
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DOI：
10.1016/j.forsciint.2010.10.025
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发表时间：
2011-05-20
影响因子：
2.2
通讯作者：
Wolf, Gerald
中科院分区：
文献类型：
--
作者：
Arndt, Torsten;Claussen, Ulrich;Wolf, Gerald
目的：一个戒毒和戒酒康复中心要求对一名前阿片类药物成瘾妇女尿液中的“氪”进行分析。3个月后，患者的临床表现和行为发生改变，伴有瞳孔缩小、瘙痒、躁动和中度欣快感。文献检索显示，“氪”据说含有“Kratom”（米特拉吉那的叶子），但也可能含有o -去甲基曲马多（欧洲药物和药物成瘾监测中心的专题论文“香料”）。方法：采用试纸（nal von minden, Regensburg, Germany）和克隆酶供体免疫测定法（Microgenics, Passau, Germany）进行免疫药物筛选。采用LC-MS/MS （ThermoFisher Scientific Quantum Ultra三重四极杆质谱仪）对“Kratom”生物碱和曲马多（代谢物）进行分析。结果：安非他命、巴比妥类药物、苯二氮卓类药物、苯甲酰ecgonine、丁丙诺啡、乙基葡萄糖醛酸盐、美沙酮（代谢物）、阿片类药物、羟考酮、四氢大麻酚（THC-COOH）免疫检测均为阴性，曲马多及其代谢物（o -去甲基曲马多截止值为10 mg/L）免疫检测均为阴性。LC-MS/MS检测到“Kratom”生物碱米特拉吉碱、特比吉碱、特比吉碱、米特拉吉碱、paynantheine和o -去甲基曲马多约9 mg/L，但未检测到曲马多和n -去甲基曲马多。讨论：检测到斑孢菌的生物碱是滥用“Kratom”的证据。面对分析数据，患者承认服用了3-4次“氪”。o -去甲基曲马多的来源尚不清楚。由于未检测到曲马多和n -去甲基曲马多（摄入曲马多后尿液中的生理反应），因此不太可能存在曲马多滥用。服用含有o -去甲基曲马多的“氪”产品可以解释我们的发现和患者的临床症状。这将与最近的一份报告一致，该报告将明显天然的草药混合物与合成阿片类药物o -去甲基曲马多混合在一起。结论：对“苦参”滥用的分析不应局限于黄芪生物碱，而应考虑可添加到复方中草药中的合成药物。基于质谱的药物筛选将越来越重要，以跟上动态药物市场的步伐。2010爱思唯尔爱尔兰有限公司版权所有。
Aim: A drug and alcohol withdrawal rehabilitation centre requested an analysis for "Krypton" in urine of a former opiate-addictive woman. She showed an altered clinical picture and behaviour with miosis, itchiness, agitation, and moderate euphoria after 3 months of until than successful treatment. Literature search revealed that "Krypton" is said to contain "Kratom" (leaves of Mitragyna speciosa), but could also contain O-desmethyltramadol (European Monitoring Centre for Drugs and Drug Addiction thematic paper "Spice").Methods: Immunological drug screenings were done with test strips (nal von minden, Regensburg, Germany) and with cloned enzyme donor immunoassay (Microgenics, Passau, Germany). "Kratom" alkaloids and tramadol (metabolites) were analyzed by LC-MS/MS (ThermoFisher Scientific Quantum Ultra Triple Quadrupole mass spectrometer).Results: Immunoassays were negative for amphetamines, barbiturates, benzodiazepines, benzoylecgonine, buprenorphine, ethylglucuronide, methadone (metabolite), opiates, oxycodone, and THC-COOH, and test strips were negative for tramadol and its metabolites (cut-off 10 mg/L for O-desmethyltramadol). LC-MS/MS detected the "Kratom" alkaloids mitragynine, speciociliatine, speciogynine, mitraciliatine, and paynantheine and approximately 9 mg/L O-desmethyltramadol, but no tramadol and N-desmethyltramadol.Discussion: The detection of M. speciosa alkaloids is a proof of "Kratom" abuse. Confronted with the analysis data, the patient admitted to have consumed 3-4 infusions of "Krypton". The origin of the O-desmethyltramadol is unclear. Tramadol abuse is unlikely since tramadol and N-desmethyltramadol (physiologically occurring in urine after tramadol intake) were not detectable. Consumption of a "Krypton" product spiked with O-desmethyltramadol could explain our findings and the patient's clinical picture. This would be in agreement with a most recent report about spiking apparently natural herbal mixtures with the synthetic opioid O-desmethyltramadol.Conclusion: Analysis of "Kratom" abuse should not be restricted to M. speciosa alkaloids, but should also consider synthetic drugs which could be added to the herbal mixtures. Mass spectrometry based drug screenings will gain importance to keep pace with the dynamic drug market. (c) 2010 Elsevier Ireland Ltd. All rights reserved.