Lund Kyle, Srihari Priya, Suhandynata Raymond T, Schwartz Kristy, Fitzgerald Robert L, Kreshak Allyson A
Department of Pathology, Center for Advanced Laboratory Medicine, UC San Diego Health, 10300 Campus Point Dr. Suite 150, San Diego, CA 92121, USA.
Department of Emergency Medicine, Keck School of Medicine of USC, 1200 N. State Street Room 1060R, Los Angeles, CA 90033, USA.
J Anal Toxicol. 2021 Sep 21. doi: 10.1093/jat/bkab103.
Methaqualone, known previously under the brand name Quaalude, is a Schedule I sedative hypnotic drug that may cause neurotoxicity in overdose, characterized by somnolence, hyperreflexia and muscular hyperactivity. We present a case of a 21-year-old male who reportedly ingested methaqualone in addition to insufflation of street cocaine. He subsequently developed hypoxia, hyperreflexia, myoclonus, and altered mental status. His laboratory results were notable for the presence of methemoglobinemia, which was most likely due to a cocaine contaminant. Laboratory analysis of the alleged methaqualone pills identified the substance as SL-164, a dichlorinated methaqualone analog. Urine toxicology results were positive for SL-164 (and presumed metabolites) as well as for cocaine and tetrahydrocannabinol metabolites. The patient was treated with supplemental oxygen and a benzodiazepine (lorazepam) and observed in the Emergency Department (ED) until his symptoms resolved. This case highlights current community access to methaqualone analogs. The case also focuses on laboratory techniques used to identify the methaqualone analog.
甲喹酮，曾用品牌名安眠酮，是一种附表一的镇静催眠药，过量服用可能导致神经毒性，表现为嗜睡、反射亢进和肌肉活动亢进。我们报告一例21岁男性病例，据报道该患者除吸食街头可卡因外还摄入了甲喹酮。随后他出现了缺氧、反射亢进、肌阵挛和精神状态改变。他的实验室检查结果显示存在高铁血红蛋白血症，这很可能是由于可卡因污染物所致。对所谓的甲喹酮药丸进行实验室分析后确定该物质为SL - 164，一种二氯甲喹酮类似物。尿液毒理学检测结果显示SL - 164（以及推测的代谢物）、可卡因和四氢大麻酚代谢物呈阳性。该患者接受了补充氧气和苯二氮䓬类药物（劳拉西泮）治疗，并在急诊科观察直至症状缓解。该病例凸显了当前社区中甲喹酮类似物的可获得性。该病例还聚焦于用于识别甲喹酮类似物的实验室技术。
