Johansson Anna, Lindstedt Daniel, Roman Markus, Thelander Gunilla, Nielsen Elisabet I, Lennborn Ulrica, Sandler Håkan, Rubertsson Sten, Ahlner Johan, Kronstrand Robert, Kugelberg Fredrik C
Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Linköping, Sweden.
Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Linköping, Sweden.
Forensic Sci Int. 2017 Jun;275:76-82. doi: 10.1016/j.forsciint.2017.02.034. Epub 2017 Mar 7.
3-methoxyphencyclidine (3-MeO-PCP) appeared on the illicit drug market in 2011 and is an analogue of phencyclidine, which exhibits anesthetic, analgesic and hallucinogenic properties. In this paper, we report data from a non-fatal intoxication and seven deaths involving 3-MeO-PCP in Sweden during the period March 2014 until June 2016.
The non-fatal intoxication case, a 19-year-old male with drug problems and a medical history of depression, was found awake but tachycardic, hypertensive, tachypnoeic and catatonic at home. After being hospitalized, his condition worsened as he developed a fever and lactic acidosis concomitant with psychomotor agitation and hallucinations. After 22h of intensive care, the patient had made a complete recovery. During his hospitalization, a total of four blood samples were collected at different time points. The seven autopsy cases, six males and one female, were all in their twenties to thirties with psychiatric problems and/or an ongoing drug abuse.
3-MeO-PCP was identified with liquid chromatography (LC)/time-of-flight technology and quantified using LC-tandem mass spectrometry.
In the clinical case, the concentration of 3-MeO-PCP was 0.14μg/g at admission, 0.08μg/g 2.5h after admission, 0.06μg/g 5h after admission and 0.04μg/g 17h after admission. The half-life of 3-MeO-PCP was estimated to 11h. In the autopsy cases, femoral blood concentrations ranged from 0.05μg/g to 0.38μg/g. 3-MeO-PCP was the sole finding in the case with the highest concentration and the cause of death was established as intoxication with 3-MeO-PCP. In the remaining six autopsy cases, other medications and drugs of abuse were present as well.
Despite being scheduled in January 2015, 3-MeO-PCP continues to be abused in Sweden. Exposure to 3-MeO-PCP may cause severe adverse events and even death, especially if the user does not receive life-supporting treatment.
3-甲氧基苯环己哌啶（3-MeO-PCP）于2011年出现在非法药物市场，它是苯环己哌啶的类似物，具有麻醉、镇痛和致幻特性。在本文中，我们报告了2014年3月至2016年6月期间瑞典发生的1例3-MeO-PCP非致命中毒事件及7例死亡案例的数据。
非致命中毒案例中的患者为一名19岁男性，有药物问题且有抑郁症病史，在家中被发现时清醒，但心动过速、高血压、呼吸急促且呈紧张症状态。住院后，他的病情恶化，出现发热和乳酸酸中毒，并伴有精神运动性激越和幻觉。经过22小时的重症监护，患者完全康复。住院期间，在不同时间点共采集了4份血样。7例尸检案例中，6例男性和1例女性，年龄均在二十多岁至三十多岁，有精神问题和/或持续的药物滥用情况。
采用液相色谱（LC）/飞行时间技术鉴定3-MeO-PCP，并使用LC串联质谱法进行定量。
在临床案例中，入院时3-MeO-PCP的浓度为0.14μg/g，入院后2.5小时为0.08μg/g，入院后5小时为0.06μg/g，入院后17小时为0.04μg/g。3-MeO-PCP的半衰期估计为11小时。在尸检案例中，股血浓度范围为0.05μg/g至0.38μg/g。在浓度最高的案例中，3-MeO-PCP是唯一发现的物质，死亡原因确定为3-MeO-PCP中毒。在其余6例尸检案例中，还存在其他药物和滥用药物。
尽管3-MeO-PCP在2015年1月被列入管制，但在瑞典仍有人滥用。接触3-MeO-PCP可能导致严重不良事件甚至死亡，尤其是在使用者未接受生命支持治疗的情况下。
