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Espinoza W, Vargas Jentzsch P, Gualpa F, Andrade P, Moreno C, Vaca I, Betancourt R, Medina L, Enríquez D, Guijarro M, Garrido P, Bravo J, Ulic S, Montalvo García G, Ortega F, Stolker L, Ramos L. Survey of clenbuterol in bovine muscle and liver in Ecuador. FOOD ADDITIVES & CONTAMINANTS PART B-SURVEILLANCE 2020; 13:107-114. [PMID: 32151232 DOI: 10.1080/19393210.2020.1735534] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Clenbuterol is a steroid-type drug used in respiratory treatments in both humans and animals. However, it has a secondary effect related to the hypertrophy process in muscle and fat reduction. The illegal or bad use of clenbuterol has been reported in several countries, but there is scarce information in South America, where the production and consumption of meat are considerable. In this sense, the present study aimed at evaluating the occurrence of clenbuterol in bovine muscle and liver samples from a high cattle production area of Ecuador in 2015 and 2018. For this purpose, 57-58 samples were evaluated in 2015 and 20 samples in 2018 using the Enzyme-Linked Inmuno Sorbent Assay and ultrahigh-performance liquid chromatography-tandem mass spectrometry. The results showed complained results for clenbuterol in meat samples from both years and 23% (2015) and 85% (2018) of the samples of meat complied the maximum residue level defined by CODEX.
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Affiliation(s)
- Wania Espinoza
- Coordinación de Posgrados, Universidad del Azuay , Cuenca, Ecuador
| | - Paul Vargas Jentzsch
- Departamento de Ciencias Nucleares, Facultad de Ingeniería Química y Agroindustria, Escuela Politécnica Nacional , Quito, Ecuador
| | | | - Paulette Andrade
- Agencia de Regulación Fito y Zoosanitario_AGROCALIDAD , Tumbaco, Ecuador
| | - Carla Moreno
- Agencia de Regulación Fito y Zoosanitario_AGROCALIDAD , Tumbaco, Ecuador
| | - Israel Vaca
- Agencia de Regulación Fito y Zoosanitario_AGROCALIDAD , Tumbaco, Ecuador
| | - Rommel Betancourt
- Agencia de Regulación Fito y Zoosanitario_AGROCALIDAD , Tumbaco, Ecuador
| | - Lorena Medina
- Instituto Interamericano de Cooperación Agropecuaria_IICA_Ecuador , Quito, Ecuador
| | - Dominique Enríquez
- Centro de Investigación de Alimentos, CIAL, Universidad UTE , Quito, Ecuador
| | - Michelle Guijarro
- Centro de Investigación de Alimentos, CIAL, Universidad UTE , Quito, Ecuador
| | - Patricia Garrido
- Centro de Investigación de Alimentos, CIAL, Universidad UTE , Quito, Ecuador
| | - Juan Bravo
- Centro de Investigación de Alimentos, CIAL, Universidad UTE , Quito, Ecuador
| | - Sonia Ulic
- CEQUINOR (UNLP-CONICET), Universidad Nacional de La Plata , La Plata, Argentina.,Depto de Cs. Básicas, Universidad Nacional de Luján , Luján, Argentina
| | - Gemma Montalvo García
- Departamento de Química Analítica, Química Física e Ingeniería Química, e Instituto Universitario de Investigación en Ciencias Policiales, Universidad de Alcalá , Alcalá de Henares, Spain
| | - Fernando Ortega
- Departamento de Química Analítica, Química Física e Ingeniería Química, e Instituto Universitario de Investigación en Ciencias Policiales, Universidad de Alcalá , Alcalá de Henares, Spain
| | - Linda Stolker
- Wageningen Food Safety Research Part of Wageningen University & Research , Wageningen, The Netherlands
| | - Luis Ramos
- Centro de Investigación de Alimentos, CIAL, Universidad UTE , Quito, Ecuador
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2
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Dufayet L, Gorgiard C, Vayssette F, Barbet JP, Hoizey G, Ludes B. Death of an apprentice bodybuilder following 2,4-dinitrophenol and clenbuterol intake. Int J Legal Med 2020; 134:1003-1006. [PMID: 32125503 DOI: 10.1007/s00414-020-02268-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 02/21/2020] [Indexed: 12/28/2022]
Abstract
We present the case of a 17-year-old man, who died after 2,4-dinitrophenol (DNP) and clenbuterol consumption, which he likely took for physical enhancement. Forensic post-mortem examination revealed a yellowish skin colour and nonspecific signs of asphyxia. Analytical confirmation of the intoxication was obtained in blood and urine, with high levels of DNP and clenbuterol. Both of these substances are used by bodybuilders as DNP enhance lipolysis and clenbuterol has anabolic properties, but their toxicity is underestimated. DNP uncouples oxidative phosphorylation, leading to thermogenesis and even relatively small doses can cause fatal hyperthermia. Clenbuterol is a β2 agonist that causes electrolyte disturbances (hypokalemia and hyperglycemia mostly) and death have been described through coronary vasospasm. Given the circumstances in which the body was found and toxicological results, we believe the cause of death to be fatal hyperthermia from DNP intake. These substances are illegal in many countries, but easily bought online. Through this availability, the last decades have seen an increase of fatal intoxications. Websites selling them are regularly closed by French public authorities and Interpol, but unfortunately it seems insufficient.
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Affiliation(s)
- L Dufayet
- Unité Médico-Judiciaire, APHP Hôpital Hôtel Dieu, Paris, France.
- Centre antipoison de Paris, Fédération de toxicologie Fetox, APHP Hôpital Lariboisière-Fernand Widal, Paris, France.
| | - C Gorgiard
- Unité Médico-Judiciaire, APHP Hôpital Hôtel Dieu, Paris, France
- Institut Médico-Légal, Paris, France
| | | | - J P Barbet
- Service d'Anatomie Pathologique, APHP Hôpital Necker-Enfants Malades, Paris, France
| | - G Hoizey
- Laboratoire TOXLAB, Paris, France
| | - B Ludes
- Institut Médico-Légal, Paris, France
- Université de Paris, BABEL, CNRS, F-75012, Paris, France
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3
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Brent J, Burkhart K, Dargan P, Hatten B, Megarbane B, Palmer R, White J. Adverse Drug Reactions in the Intensive Care Unit. CRITICAL CARE TOXICOLOGY 2017. [PMCID: PMC7153447 DOI: 10.1007/978-3-319-17900-1_33] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Adverse drug reactions (ADRs) are undesirable effects of medications used in normal doses [1]. ADRs can occur during treatment in an intensive care unit (ICU) or result in ICU admissions. A meta-analysis of 4139 studies suggests the incidence of ADRs among hospitalized patients is 17% [2]. Because of underreporting and misdiagnosis, the incidence of ADRs may be much higher and has been reported to be as high as 36% [3]. Critically ill patients are at especially high risk because of medical complexity, numerous high-alert medications, complex and often challenging drug dosing and medication regimens, and opportunity for error related to the distractions of the ICU environment [4]. Table 1 summarizes the ADRs included in this chapter.
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Affiliation(s)
- Jeffrey Brent
- Department of Medicine, Division of Clinical Pharmacology and Toxicology, University of Colorado, School of Medicine, Aurora, Colorado USA
| | - Keith Burkhart
- FDA, Office of New Drugs/Immediate Office, Center for Drug Evaluation and Research, Silver Spring, Maryland USA
| | - Paul Dargan
- Clinical Toxicology, St Thomas’ Hospital, Silver Spring, Maryland USA
| | - Benjamin Hatten
- Toxicology Associates, University of Colorado, School of Medicine, Denver, Colorado USA
| | - Bruno Megarbane
- Medical Toxicological Intensive Care Unit, Lariboisiere Hospital, Paris-Diderot University, Paris, France
| | - Robert Palmer
- Toxicology Associates, University of Colorado, School of Medicine, Denver, Colorado USA
| | - Julian White
- Toxinology Department, Women’s and Children’s Hospital, North Adelaide, South Australia Australia
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4
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Quinley KE, Chen HY, Yang HS, Lynch KL, Olson KR. Clenbuterol causing non-ST-segment elevation myocardial infarction in a teenage female desiring to lose weight: case and brief literature review. Am J Emerg Med 2016; 34:1739.e5-7. [PMID: 26873408 DOI: 10.1016/j.ajem.2015.12.086] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Accepted: 12/31/2015] [Indexed: 10/22/2022] Open
Affiliation(s)
- Kelly E Quinley
- Department of Emergency Medicine, Highland Hospital Alameda Health System, Oakland, CA 94602.
| | - Hsien-Yi Chen
- Department of Emergency Medicine, Chang-Gung Memorial Hospital, Taoyuan, Taiwan; San Francisco Division of California Poison Control System,San Francisco, CA.
| | - He S Yang
- Department of Laboratory Medicine, University of California San Francisco, 1001 Potrero Ave, NH2M16, San Francisco, CA 94110.
| | - Kara L Lynch
- Department of Laboratory Medicine, University of California San Francisco, 1001 Potrero Ave, NH2M16, San Francisco, CA 94110.
| | - Kent R Olson
- San Francisco Division of the California Poison Control System, University of California San Francisco, San Francisco, CA 94143-1369.
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5
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Spiller HA, James KJ, Scholzen S, Borys DJ. A descriptive study of adverse events from clenbuterol misuse and abuse for weight loss and bodybuilding. Subst Abus 2014; 34:306-12. [PMID: 23844963 DOI: 10.1080/08897077.2013.772083] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Clenbuterol is a β2-agonist approved in the United States for veterinary use in nonfood animals. Clenbuterol use is emerging among bodybuilders and fitness enthusiasts attracted to the hypertrophic and lipolytic effects. CASES This was a retrospective chart review of clenbuterol exposures reported to 2 poison control centers. Misuse of clenbuterol for weight loss and bodybuilding was reported in 11 of 13 clenbuterol users. Reported clinical effects included tachycardia, widened pulse pressure, tachypnea, hypokalemia, hyperglycemia, ST changes on electrocardiogram (ECG), elevated troponin, elevated creatine phosphokinase (CPK), palpitations, chest pain, and tremor. Measured serum clenbuterol concentration was 2983 pg/mL post 4.5 mg ingestion. Co-ingestants included T3 and anabolic steroids. Treatments included activated charcoal, benzodiazepines, β-blockers, potassium replacement, and intravenous (IV) fluid. CONCLUSIONS There is an increasing use of the Internet for illicit drug use for bodybuilding and weight loss purposes. These patients may not present as the stereotype of illicit drug abusers, but as healthy athletic low-risk patients. Clinical effects persisted greater than 24 hours with evidence of myocardial injury in 2 patients. Clenbuterol is increasingly being abused within the bodybuilding subculture. These cases illustrate the hidden dangers of clenbuterol abuse among bodybuilders and fitness enthusiasts.
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Affiliation(s)
- Henry A Spiller
- Central Ohio Poison Center, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA.
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6
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Brett J, Dawson AH, Brown JA. Clenbuterol toxicity: a NSW poisons information centre experience. Med J Aust 2014; 200:219-21. [PMID: 24580525 DOI: 10.5694/mja13.10982] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Accepted: 10/01/2013] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To describe the epidemiology and toxicity of clenbuterol in exposures reported to the NSW Poisons Information Centre (NSWPIC). DESIGN AND SETTING Retrospective observational study analysing data from all calls about clenbuterol exposure recorded in the NSWPIC database from 1 January 2004 to 31 December 2012. The NSWPIC coversthe Australian jurisdictions New South Wales, Tasmania and the Australian Capital Territory 24 hours a day and provides after-hours cover for the rest of Australia for 7 nights each fortnight. MAIN OUTCOME MEASURES Total number of exposures, source of call (hospital, health care worker, member of the public), time from exposure to call, reasons for drug use, clinical features and advice given. RESULTS Callers reported 63 exposures to clenbuterol, with a dramatic increase from three in 2008 to 27 in 2012. Of the 63 calls, 35 were from hospital, two from paramedics, one from general practice and 21 direct from the public. At least 53 patients (84%) required hospitalisation. The commonest reasons for use were bodybuilding and slimming. The most common features were tachycardia (24 patients), gastrointestinal disturbance (16) and tremor (11). Exposure was also associated with cardiotoxicity including one cardiac arrest in a 21-year-old man. CONCLUSION Although a well recognised doping issue among elite athletes, clenbuterol use has spread out into the general public, especially during 2012, and should be considered in patients using bodybuilding or slimming products who present with protracted sympathomimetic features. The potential for misuse of this substance requires reconsideration of its current poison schedule registration and its availability.
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Affiliation(s)
- Jonathan Brett
- Drug Health, Royal Prince Alfred Hospital, Sydney, NSW, Australia.
| | - Andrew H Dawson
- NSW Poisons Information Centre, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Jared A Brown
- NSW Poisons Information Centre, The Children's Hospital at Westmead, Sydney, NSW, Australia
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Hepworth‐Warren KL, Alcott CJ. Treatment and resolution of zilpaterol hydrochloride toxicity in a
Q
uarter
H
orse gelding. EQUINE VET EDUC 2013. [DOI: 10.1111/eve.12092] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- K. L. Hepworth‐Warren
- Lloyd Veterinary Medical CenterCollege of Veterinary MedicineIowa State University Ames Iowa USA
| | - C. J. Alcott
- Lloyd Veterinary Medical CenterCollege of Veterinary MedicineIowa State University Ames Iowa USA
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9
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Ryall JG, Lynch GS. The potential and the pitfalls of β-adrenoceptor agonists for the management of skeletal muscle wasting. Pharmacol Ther 2008; 120:219-32. [DOI: 10.1016/j.pharmthera.2008.06.003] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2008] [Accepted: 06/04/2008] [Indexed: 01/08/2023]
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