a Associate Clinical Professor of Emergency Medicine, Department of Emergency Medicine , University of Kansas Hospital , Kansas City , KS , USA.
b Staff Research Associate, Department of Laboratory Medicine , University of California-San Francisco, San Francisco General Hospital , San Francisco , CA , USA.
J Psychoactive Drugs. 2017 Sep-Oct;49(4):289-293. doi: 10.1080/02791072.2017.1333660. Epub 2017 Jun 7.
Methoxetamine and 3-methoxy-phencyclidine are novel arylcyclohexylamines whose use and clinical toxicity are poorly reported in the medical literature. We report a case of analytically confirmed use of both methoxetamine and 3-methoxy-phencyclidine.
A 27-year-old male presented 10 hours after insufflating an Internet-obtained powder. He was hypertensive, tachycardic, and demonstrated dissociated affect, a delayed verbal response to questions, ataxia, and vertical nystagmus. A urine drug screen was positive for phencyclidine and 11-nor-delta9-THC-9-carboxylic acid. He was admitted and his mental status and blood pressure normalized eight hours later. Blood samples (0, 2, and 3 hours from arrival) and the powders were analyzed by liquid chromatography-quadrupole time-of-flight mass spectrometry. Methoxetamine and 3-methoxy-phencyclidine were detected in all samples (279 ng/ml, 205 ng/ml, and 180 ng/ml for methoxetamine; 167 ng/mL, 131 ng/mL, and 90 ng/ml for 3-methoxy-phencyclidine at 0, 2, and 3 hours, respectively). No phencyclidine or tetrahydrocannabinol was detected. Two powders contained methoxetamine while one contained 3-methoxy-phencyclidine.
The literature regarding methoxetamine and 3-methoxy-phencyclidine toxicity is limited. Methoxetamine use is associated with altered mental status, ataxia, and hypertension. Toxicity from 3-methoxy-phencyclidine is poorly described. There is no prior case describing serial qualitative analysis. Health care providers should be aware of the novel arylcyclohexylamines and their toxicity.
甲氧基埃托啡和 3-甲氧基苯环利定是新型的芳基环己基胺类药物，其在医学文献中的使用和临床毒性报道甚少。我们报告了一例经分析证实使用甲氧基埃托啡和 3-甲氧基苯环利定的病例。
一名 27 岁男性在吸入一种从互联网上获取的粉末后 10 小时就诊。他表现为高血压、心动过速，并出现分离性情感、对问题的语言反应延迟、共济失调和垂直性眼球震颤。尿液药物筛查呈苯环利定和 11-去甲-9-四氢大麻酚-9-羧酸阳性。他被收入院，8 小时后精神状态和血压恢复正常。血液样本（到达时的 0、2 和 3 小时）和粉末通过液相色谱-四极杆飞行时间质谱进行分析。所有样本中均检测到甲氧基埃托啡和 3-甲氧基苯环利定（甲氧基埃托啡在 0、2 和 3 小时的浓度分别为 279ng/ml、205ng/ml 和 180ng/ml；3-甲氧基苯环利定分别为 167ng/ml、131ng/ml 和 90ng/ml）。未检测到苯环利定或四氢大麻酚。两种粉末中含有甲氧基埃托啡，而一种粉末中含有 3-甲氧基苯环利定。
关于甲氧基埃托啡和 3-甲氧基苯环利定毒性的文献有限。甲氧基埃托啡的使用与精神状态改变、共济失调和高血压有关。3-甲氧基苯环利定的毒性描述甚少。没有之前描述连续定性分析的病例。医疗保健提供者应了解新型芳基环己基胺类药物及其毒性。
