New psychoactive substance cocktail in an intensive care intoxication case elucidated by molecular networking.
Romain Pelletier, Brendan Le Daré, Loic Grandin, Aurélien Couette, Pierre-Jean Ferron, Isabelle Morel, Thomas Gicquel
Clinical toxicology (Philadelphia, Pa.) January 1, 2022 DOI: 10.1080/15563650.2021.1931693 via PubMed
Summary
AI-generated from the abstractA 37-year-old man with a history of drug abuse was found unconscious with bags of powder labeled as research chemicals and traces of powder on his nose. He was rehydrated, intubated, and admitted to the intensive care unit. Urine analysis identified several new psychoactive substances, including high concentrations of 3-OH-PCP (12,085 mg/L) and 3-MeO-PCP (1,100 mg/L), along with 2F-DCK, N-ethylhexedrone, and CMC. Molecular networking, a bioinformatic approach, confirmed that the powders in the bags matched the substances found in the patient's urine. This case demonstrates how molecular networking can aid in sample comparison, target quantification methods, and support treatment decisions for intoxications involving arylcyclohexylamine compounds.
Study at a glance
| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | A 37-year-old man with a history of drug abuse admitted to the intensive care unit |
| Keywords | New psychoactive substances Intensive care Intoxication Ketamine derivatives Molecular networking |
| Citations | 22 |
| Key finding | Molecular networking confirmed that the arylcyclohexylamine compounds found in the patient's urine matched the powders in the bags, illustrating its utility in managing non-fatal intoxications. |
Abstract
The recreational use of new psychoactive substances (NPS) is increasing worldwide. Among them, the arylcyclohexylamine family including phencyclidine (PCP) and ketamine derivatives is increasing. We report a non-fatal intoxication mainly due to arylcyclohexylamine compounds illustrated by molecular networking (MN). A 37-year-old man with a history of drug abuse was discovered with several bags labeled as research chemicals around him and traces of powder on his nose. He was rehydrated, intubated, and admitted to the intensive care unit (ICU). Urine and drug were analyzed by liquid chromatography-mass spectrometry for NPS identification. Several NPS were quantified in urine: 3-OH-PCP at 12,085 mg/L, 3-MeO-PCP at 1100 mg/L, 2F-DCK at 147 mg/L, N-ethylhexedrone at 165 mg/L and CMC at 48 mg/L. Using a bioinformatic approach, a molecular network was built to confirm the consumption of powders contained in the bags by comparison with patient's urine. This case illustrates the interest of MN to (i) perform sample-to-sample comparison, (ii) target quantification methods, and (iii) allow proper management to confirm the relevance of the treatment.