Unintentional Fatal Intoxications with Mitragynine and O-Desmethyltramadol from the Herbal Blend Krypton
Unintentional Fatal Intoxications with Mitragynine and O-Desmethyltramadol from the Herbal Blend Krypton
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DOI：
10.1093/anatox/35.4.242
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发表时间：
2011-05-01
影响因子：
2.5
通讯作者：
Eriksson, Anders
中科院分区：
文献类型：
--
作者：
Kronstrand, Robert;Roman, Markus;Eriksson, Anders
Kratom的叶子，在东南亚的药用植物，已被用作草药很长一段时间. Kratom中存在的生物碱中的至少一种，mitragynine，是μ受体激动剂. Kratom和另一种名为Krypton的制剂都可以通过互联网获得。它似乎包括粉末Kratom叶与另一种μ受体激动剂，O-去甲基曲马多，添加. O-去甲基曲马多是曲马多的活性代谢物，一种常用的处方镇痛药.我们提出了9例中毒，发生在一个时期内不到一年，其中两个mitragynine andO-去甲基曲马多在尸检血液样本中检测.这些样本中既不存在曲马多，也不存在N-去甲基曲马多，这意味着摄入的药物是O-去甲基曲马多。通过超高效液相色谱-串联质谱法测定的mitragynine的血液浓度范围为0.02至0.18 µg/g，通过气相色谱氮特异性检测测定的O-去甲基曲马多浓度范围为0.4至4.3 µg/g。我们认为，除了有效的μ受体激动剂O-去甲基曲马多粉叶Kratom促成了意外死亡的九个案件，并得出结论，摄入氪不是无害的，因为它往往是在互联网网站上描述.
The leaves of Kratom, a medicinal plant in Southeast Asia, have been used as an herbal drug for a long time. At least one of the alkaloids present in Kratom, mitragynine, is a mu-receptor agonist. Both Kratom and an additional preparation called Krypton are available via the internet. It seems to consist of powdered Kratom leaves with another mu-receptor agonist,O-desmethyltramadol, added.O-Desmethyltramadol is an active metabolite of tramadol, a commonly prescribed analgesic.We present nine cases of intoxication, occurring in a period of less than one year, where both mitragynine andO-desmethyltramadol were detected in the postmortem blood samples. Neither tramadol norN-desmethyltramadol was present in these samples, which implies that the ingested drug wasO-desmethyltramadol. The blood concentrations of mitragynine, determined by ultra-performance liquid chromatography-tandem mass spectrometry, ranged from 0.02 to 0.18 µg/g, andO-desmethyltramadol concentrations, determined by gas chromatography with nitrogen-specific detection, ranged from 0.4 to 4.3 µg/g. We believe that the addition of the potent mu-receptor agonistO-desmethyltramadol to powdered leaves from Kratom contributed to the unintentional death of the nine cases presented and conclude that intake of Krypton is not as harmless as it often is described on internet websites.