ABSTRACT
Methylmethaqualone is a sedative designer drug created by adding a methyl group to the 3-phenyl ring of methaqualone, and is at present not subject to restrictive regulation in many countries. To our knowledge, no case of methylmethaqualone abuse has been published to date in the scientific literature, and the only sources of information are users' reports on Web discussion forums and data from preclinical animal studies. We report a case of oral methylmethaqualone abuse confirmed by liquid chromatography tandem mass spectrometry in a 24-year-old previously healthy Caucasian male. Observed symptoms and signs such as central nervous system depression alternating with excitation, psychomotor agitation, muscle hyperactivity, and tachycardia were compatible with methaqualone-induced adverse effects. Except for the mild tachycardia (115 beats/min), other vital signs were normal: blood pressure 134/89 mmHg, body temperature 36.2°C (97.16°F), and peripheral oxygen saturation 99% while breathing room air. The ECG showed no prolongation of the QT interval and the QRS duration was normal. Laboratory analysis revealed a slight increase in creatine kinase (368 U/L) and alanine aminotransferase (90 U/L) serum concentrations. Blood alcohol concentration was 0.32 g/L. Methylmethaqualone was identified in a serum sample collected on admission which was analyzed by a liquid chromatography tandem mass spectrometry toxicological screening method using turbulent flow online extraction. After a few days the patient ingested the same amount of substance with identical symptoms. Based on the chemical structure and animal data, and according to this case report and users' Web reports, methylmethaqualone appears to have a similar acute toxicity profile to methaqualone, with marked psychomotor stimulation. Symptoms of acute toxicity can be expected to resolve with supportive care.
Subject(s)
Designer Drugs/toxicity , Hypnotics and Sedatives/toxicity , Methaqualone/analogs & derivatives , Neurotoxicity Syndromes/blood , Adult , Chromatography, High Pressure Liquid , Designer Drugs/analysis , Designer Drugs/pharmacokinetics , Humans , Hypnotics and Sedatives/blood , Hypnotics and Sedatives/pharmacokinetics , Male , Methaqualone/blood , Methaqualone/pharmacokinetics , Methaqualone/toxicity , Methylation , Neurotoxicity Syndromes/physiopathology , Neurotoxicity Syndromes/therapy , Severity of Illness Index , Tandem Mass Spectrometry , Treatment Outcome , Young AdultABSTRACT
A HPLC method for quantification of kebuzone and its metabolites in whole blood was developed. The compounds and the internal standard were isolated from blood by solid-phase extraction on a C-18 cartridge. A blood sample was to be hemolyzed before extraction. HPLC was performed on a C-18 column with the mobile phase composed of methanol/water acidified to pH 2.7 and UV absorbance detection at 247 nm. This method has been successfully applied to a pharmacokinetic study of kebuzone and its metabolites in rabbits.
Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/blood , Phenylbutazone/analogs & derivatives , Animals , Anti-Inflammatory Agents, Non-Steroidal/pharmacokinetics , Central Nervous System Depressants/blood , Central Nervous System Depressants/pharmacokinetics , Chromatography, High Pressure Liquid , Methaqualone/blood , Methaqualone/pharmacokinetics , Phenylbutazone/blood , Phenylbutazone/pharmacokinetics , Rabbits , Spectrophotometry, UltravioletABSTRACT
The adsorber Wofatit Y 88 (VEB Chemiekombinat Bitterfeld) was tested regarding its adsorption properties in comparison with Hämoresin (B. Braun, Melsungen, FRG) Hemosorbent SKN-2K (USSR) and the own product Wofatit UH 91. As adsorptives the hypnotics Metaqualon, Pyrithyldion, Crotylbarbital and Phenobarbital were used. The investigation have been performed in a single-pass system in a relation of 1:25 to the clinical practice conditions. The concentration measurements to the estimation of adsorbed amounts were made by UV-VIS spectrometry. It was found that Wofatit Y 88 is superior to Hämoresin with regard to adsorbed amounts and adsorption speed. For all drugs Wofatit Y 88 was superior to UH 91.
