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Barceló B, Gomila I, de-Castro-Ríos A, Perez-Barcena J, Jimenez C, Lendoiro E, Elorza MÁ. Diminished Consciousness in a Woman Following an Unsuspected Scopolamine Overdose. J Anal Toxicol 2021; 45:e7-e14. [PMID: 33025011 DOI: 10.1093/jat/bkaa135] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/20/2020] [Accepted: 09/28/2020] [Indexed: 11/12/2022] Open
Abstract
Scopolamine is used clinically, but it is also used as a recreational drug and as an incapacitating drug, in sexual crimes and robberies. In this paper, the authors report the case of a woman with a diminished consciousness following an unsuspected overdose with scopolamine and review published articles on scopolamine poisoning that included concentrations in biological samples. Scopolamine was identified in the patient's serum and urine samples collected 1 h post-admission to intensive care unit at concentrations of 8.4 ng/mL and 62,560 ng/mL (169,539 ng/mg creatinine), respectively. In non-fatal cases, the median [interquartile range] of serum scopolamine levels was 1.9 [2.1] ng/mL. The serum concentration found in our case would explain the abrupt clinical presentation suffered by the patient. Scopolamine in urine could be detected up to 48 h after admission. This report illustrates that broad toxicology screening, including scopolamine, should be considered when patients with diminished consciousness are attended after ruling out infection or cerebrovascular disease. This can play an important role in identifying this potentially life-threatening etiology.
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Affiliation(s)
- Bernardino Barceló
- Clinical Toxicology Unit, Clinical Analysis Department, Hospital Universitari Son Espases. Research Institute of Health Sciences (IdISBa), Valldemossa road 79, 07120 Palma de Mallorca, Spain
| | - Isabel Gomila
- Clinical Analysis Department, Hospital Universitari Son Llàtzer. Research Institute of Health Sciences (IdISBa), Manacor road, 07198 Palma de Mallorca, Spain
| | - Ana de-Castro-Ríos
- Servicio de Toxicología, Instituto de Ciencias Forenses "Luis Concheiro". Universidade de Santiago de Compostela, San Francisco s/n, 15782 Santiago de Compostela, Spain
| | - Jon Perez-Barcena
- Intensive Care Department, Hospital Universitari Son Espases, Research Institute of Health Sciences (IdISBa), Valldemossa road 79, 07120 Palma de Mallorca, Spain
| | - Carmen Jimenez
- Neurology Department, Hospital Universitari Son Espases, Research Institute of Health Sciences (IdISBa), Valldemossa road 79, 07120 Palma de Mallorca, Spain
| | - Elena Lendoiro
- Servicio de Toxicología, Instituto de Ciencias Forenses "Luis Concheiro". Universidade de Santiago de Compostela, San Francisco s/n, 15782 Santiago de Compostela, Spain
| | - Miguel Ángel Elorza
- Clinical Toxicology Unit, Clinical Analysis Department, Hospital Universitari Son Espases. Research Institute of Health Sciences (IdISBa), Valldemossa road 79, 07120 Palma de Mallorca, Spain
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Overview of the major classes of new psychoactive substances, psychoactive effects, analytical determination and conformational analysis of selected illegal drugs. OPEN CHEM 2021. [DOI: 10.1515/chem-2021-0196] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Abstract
The misuse of psychoactive substances is attracting a great deal of attention from the general public. An increase use of psychoactive substances is observed among young people who do not have enough awareness of the harmful effects of these substances. Easy access to illicit drugs at low cost and lack of effective means of routine screening for new psychoactive substances (NPS) have contributed to the rapid increase in their use. New research and evidence suggest that drug use can cause a variety of adverse psychological and physiological effects on human health (anxiety, panic, paranoia, psychosis, and seizures). We describe different classes of these NPS drugs with emphasis on the methods used to identify them and the identification of their metabolites in biological specimens. This is the first review that thoroughly gives the literature on both natural and synthetic illegal drugs with old known data and very hot new topics and investigations, which enables the researcher to use it as a starting point in the literature exploration and planning of the own research. For the first time, the conformational analysis was done for selected illegal drugs, giving rise to the search of the biologically active conformations both theoretically and using lab experiments.
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Beyramysoltan S, Abdul-Rahman NH, Musah RA. Call it a “nightshade”—A hierarchical classification approach to identification of hallucinogenic Solanaceae spp. using DART-HRMS-derived chemical signatures. Talanta 2019; 204:739-746. [DOI: 10.1016/j.talanta.2019.06.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 05/31/2019] [Accepted: 06/03/2019] [Indexed: 10/26/2022]
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Lo Faro AF, Di Trana A, La Maida N, Tagliabracci A, Giorgetti R, Busardò FP. Biomedical analysis of New Psychoactive Substances (NPS) of natural origin. J Pharm Biomed Anal 2019; 179:112945. [PMID: 31704129 DOI: 10.1016/j.jpba.2019.112945] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 10/16/2019] [Accepted: 10/18/2019] [Indexed: 12/16/2022]
Abstract
New psychoactive substances (NPS) can be divided into two main groups: synthetic molecules and active principles of natural origin. With respect to this latter group, a wide range of alkaloids contained in plants, mainly from Asia and South America, can be included in the class of NPS of natural origin. The majority NPS of natural origin presents stimulant and/or hallucinogenic effects (e.g. Catha edulis and Ayahuasca, respectively) while few of them show sedative and relaxing properties (e.g. kratom). Few information is available in relation to the analytical identification of psychoactive principles contained in the plant material. Moreover, to our knowledge, scarce data are present in literature, about the characterization and quantification of the parent drug in biological matrices from intoxication and fatality cases. In addition, the metabolism of natural active principles has not been yet fully investigated for most of the psychoactive substances from plant material. Consequently, their identification is not frequently performed and produced metabolites are often unknown. To fill this gap, we reviewed the currently available analytical methodologies for the identification and quantification of NPS of natural origin in plant material and, whenever possible, in conventional and non-conventional biological matrices of intoxicated and dead subjects. The psychoactive principles contained in the following plants were investigated: Areca catechu, Argyreia nervosa, Ayahuasca, Catha edulis, Ipomoea violacea, Mandragora officinarum, Mitragyna speciosa, Pausinystalia yohimbe, Piper methisticum, Psilocybe, Rivea corymbosa, Salvia divinorum, Sceletium tortuosum, Lactuca virosa. From the results obtained, it can be evidenced that although several analytical methods for the simultaneous quantification of different molecules from the same plants have been developed and validated, a comprehensive method to detect active compounds from different natural specimens both in biological and non-biological matrices is still lacking.
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Affiliation(s)
- Alfredo Fabrizio Lo Faro
- Department of Excellence of Biomedical Sciences and Public Health, University "Politecnica delle Marche" of Ancona, Via Tronto 71, Ancona, Italy
| | - Annagiulia Di Trana
- Department of Excellence of Biomedical Sciences and Public Health, University "Politecnica delle Marche" of Ancona, Via Tronto 71, Ancona, Italy
| | - Nunzia La Maida
- Department of Excellence of Biomedical Sciences and Public Health, University "Politecnica delle Marche" of Ancona, Via Tronto 71, Ancona, Italy
| | - Adriano Tagliabracci
- Department of Excellence of Biomedical Sciences and Public Health, University "Politecnica delle Marche" of Ancona, Via Tronto 71, Ancona, Italy
| | - Raffaele Giorgetti
- Department of Excellence of Biomedical Sciences and Public Health, University "Politecnica delle Marche" of Ancona, Via Tronto 71, Ancona, Italy
| | - Francesco Paolo Busardò
- Department of Excellence of Biomedical Sciences and Public Health, University "Politecnica delle Marche" of Ancona, Via Tronto 71, Ancona, Italy.
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Attempt of scopolamine-facilitated robbery: an original case of poisoning by inhalation confirmed by LC–MS/MS and review of the literature. Forensic Toxicol 2019. [DOI: 10.1007/s11419-019-00492-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Lakstygal AM, Kolesnikova TO, Khatsko SL, Zabegalov KN, Volgin AD, Demin KA, Shevyrin VA, Wappler-Guzzetta EA, Kalueff AV. DARK Classics in Chemical Neuroscience: Atropine, Scopolamine, and Other Anticholinergic Deliriant Hallucinogens. ACS Chem Neurosci 2019; 10:2144-2159. [PMID: 30566832 DOI: 10.1021/acschemneuro.8b00615] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Anticholinergic drugs based on tropane alkaloids, including atropine, scopolamine, and hyoscyamine, have been used for various medicinal and toxic purposes for millennia. These drugs are competitive antagonists of acetylcholine muscarinic (M-) receptors that potently modulate the central nervous system (CNS). Currently used clinically to treat vomiting, nausea, and bradycardia, as well as alongside other anesthetics to avoid vagal inhibition, these drugs also evoke potent psychotropic effects, including characteristic delirium-like states with hallucinations, altered mood, and cognitive deficits. Given the growing clinical importance of anti-M deliriant hallucinogens, here we discuss their use and abuse, clinical importance, and the growing value in preclinical (experimental) animal models relevant to modeling CNS functions and dysfunctions.
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Affiliation(s)
- Anton M. Lakstygal
- Graduate School of Biology, St. Petersburg State University, St. Petersburg 199034, Russia
| | | | | | | | - Andrey D. Volgin
- Institute of Experimental Medicine, Almazov National Medical Research Centre, Ministry of Healthcare of Russian Federation, St. Petersburg 197341, Russia
| | - Konstantin A. Demin
- Institute of Experimental Medicine, Almazov National Medical Research Centre, Ministry of Healthcare of Russian Federation, St. Petersburg 197341, Russia
- Institute of Translational Biomedicine (ITBM), St. Petersburg State University, St. Petersburg 199034, Russia
| | | | | | - Allan V. Kalueff
- School of Pharmacy, Southwest University, Chongqing 400700, China
- Anatomy and Physiology Laboratory, Ural Federal University, Ekaterinburg 620002, Russia
- Laboratory of Biological Psychiatry, ITBM, St Petersburg State University, St. Petersburg 199034, Russia
- Scientific Research Institute of Physiology and Basic Medicine, Novosibirsk 630117, Russia
- Granov Russian Scientific Center of Radiology and Surgical Technologies, Ministry of Healthcare of Russian Federation, St. Petersburg 197758, Russia
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Lusthof K, Bosman I, Kubat B, Vincenten-van Maanen M. Toxicological results in a fatal and two non-fatal cases of scopolamine-facilitated robberies. Forensic Sci Int 2017; 274:79-82. [DOI: 10.1016/j.forsciint.2017.01.024] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 01/25/2017] [Accepted: 01/28/2017] [Indexed: 11/29/2022]
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Diaz JH. Poisoning by Herbs and Plants: Rapid Toxidromic Classification and Diagnosis. Wilderness Environ Med 2017; 27:136-52. [PMID: 26948561 DOI: 10.1016/j.wem.2015.11.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 10/28/2015] [Accepted: 11/15/2015] [Indexed: 02/05/2023]
Abstract
The American Association of Poison Control Centers has continued to report approximately 50,000 telephone calls or 8% of incoming calls annually related to plant exposures, mostly in children. Although the frequency of plant ingestions in children is related to the presence of popular species in households, adolescents may experiment with hallucinogenic plants; and trekkers and foragers may misidentify poisonous plants as edible. Since plant exposures have continued at a constant rate, the objectives of this review were (1) to review the epidemiology of plant poisonings; and (2) to propose a rapid toxidromic classification system for highly toxic plant ingestions for field use by first responders in comparison to current classification systems. Internet search engines were queried to identify and select peer-reviewed articles on plant poisonings using the key words in order to classify plant poisonings into four specific toxidromes: cardiotoxic, neurotoxic, cytotoxic, and gastrointestinal-hepatotoxic. A simple toxidromic classification system of plant poisonings may permit rapid diagnoses of highly toxic versus less toxic and nontoxic plant ingestions both in households and outdoors; direct earlier management of potentially serious poisonings; and reduce costly inpatient evaluations for inconsequential plant ingestions. The current textbook classification schemes for plant poisonings were complex in comparison to the rapid classification system; and were based on chemical nomenclatures and pharmacological effects, and not on clearly presenting toxidromes. Validation of the rapid toxidromic classification system as compared to existing chemical classification systems for plant poisonings will require future adoption and implementation of the toxidromic system by its intended users.
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Affiliation(s)
- James H Diaz
- Department of Environmental and Occupational Health Sciences, School of Public Health; Department of Anesthesiology/Critical Care, School of Medicine, Louisiana State University Health Sciences Center (LSUHSC) in New Orleans, New Orleans, LA.
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Adamse P, van Egmond H, Noordam M, Mulder P, de Nijs M. Tropane alkaloids in food: poisoning incidents. QUALITY ASSURANCE AND SAFETY OF CROPS & FOODS 2014. [DOI: 10.3920/qas2013.0314] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- P. Adamse
- RIKILT - Wageningen UR, P.O. Box 230, 6700 AE Wageningen, the Netherlands
| | - H.P. van Egmond
- RIKILT - Wageningen UR, P.O. Box 230, 6700 AE Wageningen, the Netherlands
| | - M.Y. Noordam
- RIKILT - Wageningen UR, P.O. Box 230, 6700 AE Wageningen, the Netherlands
| | - P.P.J. Mulder
- RIKILT - Wageningen UR, P.O. Box 230, 6700 AE Wageningen, the Netherlands
| | - M. de Nijs
- RIKILT - Wageningen UR, P.O. Box 230, 6700 AE Wageningen, the Netherlands
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