Chronic escalating-dose and acute binge cocaine treatments change the hippocampal cholinergic muscarinic system on drug presence and after withdrawal.

Cocaine addiction is a relapsing disorder with loss of control in limiting drug intake. Considering the involvement of acetylcholine in the neurobiology of the disease, our aim was to evaluate whether cocaine induces plastic changes in the hippocampal cholinergic muscarinic system. Male Swiss-Webster mice received saline or cocaine (ip) three times daily (60-min intervals) either acutely or in an escalating-dose binge paradigm for 14 days. Locomotor activity was measured in all treatment days. Dopaminergic and cholinergic muscarinic receptors (D1R, D2R, M1-M5, mAChRs), choline acetyltransferase (ChAT), vesicular acetylcholine transporter (VAChT) and acetylcholinesterase (AChE) were quantified in the hippocampus by immunoblotting one hour after the last injection (on drug) or after 14 days of abstinence (withdrawal). Escalating-dose group showed cocaine-induced locomotor sensitization from day 2. M3 mAChR and ChAT significantly increased after the on-drug acute binge treatment. Escalating-dose on-drug group showed increased ChAT, M1, M5 mAChR and D2R; and decreased D1R. Acute-binge withdrawal group showed increased VAChT, M2 mAChR, D1R, and D2R; and decreased M1 mAChR. Escalating-dose withdrawal group presented increased D1R and VAChT and decreased M1 mAChR and D2R. Locomotor activity was negatively correlated with M1 mAChR and AChE in on-drug group and positively correlated with VAChT in withdrawal group. M1 mAChR was positively correlated with M2 mAChR and ChAT in on-drug group, whereas ChAT was positively correlated with M5 mAChR in withdrawal group. The results indicate that cocaine induced an increase in the hippocampal cholinergic tone in the presence of the drug, whereas withdrawal causes a resetting in the system.

Accidental ingestion of methyl ethyl ketone peroxide: N-acetylcysteine treatment and toxicological analysis.

INTRODUCTION: Methyl ethyl ketone peroxide (MEKP) is a highly toxic product which promotes tissue damage by uncontrolled free radical production. CASE REPORT: A man accidentally ingested 110 ml of MEKP (37%) at his workplace after mistaking it with a bottle of water. A loading dose of N-acetylcysteine (NAC) and subsequent maintenance doses were applied at the hospital for three consecutive days. Biochemical and hematological parameters showed significant alterations. Tracheal intubation, gastric lavage and hemodialysis were not performed. Methyl ethyl ketone (MEK) and MEKP were detected in EDTA-blood samples by GC-FID and LC-QTOF/MS respectively. An endoscopy exam identified tissue damage. The patient was admitted to the hospital for 10 days. No sequelae were reported after the MEKP poisoning. Oral administration of NAC was successful as an antidote without another approach. CONCLUSIONS: Although NAC treatment was successful, supervision after the hospitalization period was required according to the prognosis. Workplace conditions promoted anosmia, explaining the accident. MEKP and MEK were successfully detected in blood samples even with less-than-ideal storage conditions. Knowledge of MEKP dangerousness and good work practices can prevent accidental MEKP poisoning.