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J. Med. Toxicol. (2010) 6:327330 DOI 10.1007/s13181-010-0018-5
TOXICOLOGY OBSERVATION
Recreational Use of Mephedrone (4-Methylmethcathinone, 4-MMC) with Associated Sympathomimetic Toxicity
David M. Wood & Susannah Davies & Malgorzata Puchnarewicz & Jenny Button &
Roland Archer & Hanna Ovaska & John Ramsey & Terry Lee & David W. Holt &
Paul I. Dargan
Published online: 1 April 2010# American College of Medical Toxicology 2010
AbstractIntroduction Cathinone is a pharmacologically active alkaloid that can be extracted from the leaves of the khat plant (Catha edulis). There are synthetic derivatives of cathinone entering the recreational drug market, including mephe-drone (4-methylmethcathinone, 4-MMC). There are discrepancies in the legal status of both the khat plant and its extracted alkaloids between the UK and the USA.
Case Report A 22-year-old man purchased 4 g of mephe-drone powder over the Internet from a chemical supplier based in China. He initially ingested 200 mg of the mephedrone orally, with no perceived clinical effects, and thereafter injected the remaining 3.8 g intramuscularly into his thighs. Shortly after the injection, he developed
palpitations, blurred tunnel vision, chest pressure, and sweating and felt generally unwell; he presented to hospital with continuing features of sympathomimetic toxicity. His symptoms settled over the next 4 h after a single dose of oral lorazepam. Qualitative analysis of the urine and serum sample was undertaken using gas chromatography with mass spectrometric (GC/MS) detection, both positive for the presence of 4-methylmethcathinone. Quantitative analysis of the serum sample was undertaken by liquid chromatography with tandem mass spectrometric detection; the estimated mephedrone concentration was 0.15 mg/l. Routine toxicological analysis of the serum and urine specimens using a broad GC/MS toxicology screen did not detect any other drugs or alcohol.
Previous Presentations This case report was presented at the North American Congress of Clinical Toxicology, in San Antonio, TX, USA in September 2009.
D. M. Wood : P. I. DarganClinical Toxicology, Guys and St. Thomas NHS Foundation Trust and Kings Health Partners,London, UK
S. Davies : M. Puchnarewicz : J. Button : T. LeeForensic Toxicology Service, Analytical Unit, St. Georges, University of London,London, UK
R. ArcherSchool of Pharmacy and Chemistry, Kingston University, Kingston Upon Thames,London, UK
H. OvaskaGeneral Medicine and Clinical Pharmacology and Therapeutics, Guys and St. Thomas NHS Foundation Trust,London, UK
J. RamseyTICTAC Communications...