Intoxications in the STRIDA project involving a panorama of psychostimulant pyrovalerone derivatives, MDPV copycats
Intoxications in the STRIDA project involving a panorama of psychostimulant pyrovalerone derivatives, MDPV copycats
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DOI：
10.1080/15563650.2017.1370097
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发表时间：
2018-01-01
影响因子：
3.3
通讯作者：
Helander, Anders
中科院分区：
文献类型：
--
作者：
Beck, Olof;Backberg, Matilda;Helander, Anders
背景：越来越多的不同化学类别的新精神活性物质（NPS）已通过互联网营销和销售。这份来自瑞典STRIDA项目的报告介绍了5年来涉及11种兴奋剂苯戊酮NPS衍生物中毒的患病率、实验室结果和临床特征。研究设计：2011年1月至2016年3月在瑞典医院接受急诊治疗的连续入院或疑似NPS患者的病例系列。患者和方法：从瑞典各地医院的中毒患者中收集血液和尿液样本。采用免疫化学、液相色谱-质谱联用多组分法对NPS及其他滥用药物进行分析。临床数据是在咨询瑞典毒物信息中心（PIC）期间收集的，并从医疗记录中检索。该研究涉及11种苯戊酮药物的分析确诊病例。结果：在研究期间，共检出114例涉及11种新型苯戊酮药物的中毒。除这些新的邻苯戊酮衍生物外，在17例中检出3,4-亚甲基二氧基戊酮（MDPV），在45例中检出α -吡咯烷酮（pvp）。根据法医学标准鉴定，其成分为：4f - α - pvp、α - php、PV8、4Me-PPP、α - pbp、4F-PV8、α - ppp、MDPHP、α - pvt、4cl - α - pvp、4f - α - php。三种最常检测到的药物是- pbp、MDPHP和4f - α - pvp。患者年龄16-66岁（中位30岁），男性占84%。尿液和血清中的物质浓度变化很大，从1 ng/mL到300 mu g/mL不等。多种药物使用很常见，114例中只有8例（7%）涉及一种苯戊酮药物。附加物质包括其他NPS和经典精神活性药物。患者表现出多种临床体征；躁动、谵妄、幻觉、过度运动、癫痫发作、心动过速、高血压和/或高热。结论：在分析证实的nps相关中毒中，除了MDPV和α - pvp外，还发现了11种新的焦戊酮衍生物。临床特征符合拟交感神经中毒，但尿和血清浓度变化很大。结果表明，许多新型的苯戊酮类兴奋剂被引入娱乐性NPS药物市场。为了获得这一信息，分析性调查是必要的。
Context: An increasing number of new psychoactive substances (NPS) of different chemical classes have become available through marketing and sale over the Internet. This report from the Swedish STRIDA project presents the prevalence, laboratory results, and clinical features in intoxications involving 11 stimulant pyrovalerone NPS derivatives over a 5-year period.Study design: Case series of consecutive patients with admitted or suspected intake of NPS presenting to Swedish hospitals for emergency treatment from January 2011 to March 2016.Patients and method: Blood and urine samples were collected from intoxicated patients presenting to hospitals all over Sweden. Analyses of NPS and other drugs of abuse were performed by immunochemical and liquid chromatography-mass spectrometry multi-component methods. Clinical data were collected during consultation with the Swedish Poisons Information Centre (PIC), and retrieved from medical records. The study involved analytically confirmed cases with 11 pyrovalerone drugs.Results: During the study period, 114 intoxications were detected that involved any of 11 new pyrovalerone drugs. In addition to these new pyrovalerone derivatives, 3,4-methylenedioxypyrovalerone (MDPV) was detected in 17 of the cases and alpha-pyrrolidinovalerophenone (alpha-PVP) in 45 cases. Identification was made according to forensic standards and comprised the following substances: 4F-alpha-PVP, alpha-PHP, PV8, 4Me-PPP, alpha-PBP, 4F-PV8, alpha-PPP, MDPHP, alpha-PVT, 4Cl-alpha-PVP, and 4F-alpha-PHP. The three most frequently detected drugs were alpha-PBP, MDPHP, and 4F-alpha-PVP. The age range of patients was 16-66 (median 30) years and 84% were males. The substance concentrations in urine and serum were highly variable, ranging from 1 ng/mL to 300 mu g/mL. Poly-drug use was common with only 8 of 114 cases (7%) involving one pyrovalerone drug. The additional substances comprised other NPS and classical psychoactive drugs. The patients showed a variety of clinical signs; agitation, delirium, hallucinations, excessive motor activity, seizures, tachycardia, hypertension, and/or hyperthermia.Conclusions: In analytically confirmed NPS-related intoxications, 11 new pyrovalerone derivatives in addition to MDPV and alpha-PVP were found. The clinical features were consistent with a sympathomimetic toxidrome, but the urine and serum concentrations were highly variable. The results demonstrated that many novel pyrovalerone stimulants were introduced on the recreational NPS drugs market. Analytical investigations were necessary to obtain this information.