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Arantes LC, Silveira D, Magno Sousa de Azerêdo G, Enrique Estrada Semprun O, Lima de Oliveira A, Benedito LEC, Lião LM, Oliveira GDAR. Enhancing Forensic Laboratories Through University Collaboration: Obtaining Conclusive Reports and Reference Materials via NMR. MAGNETIC RESONANCE IN CHEMISTRY : MRC 2025; 63:155-166. [PMID: 39606914 DOI: 10.1002/mrc.5497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2024] [Revised: 11/07/2024] [Accepted: 11/13/2024] [Indexed: 11/29/2024]
Abstract
Forensic laboratories play a pivotal role in identifying and quantifying drugs in police seizures, often using spectroscopic techniques in combination with chromatographic methods that rely on chemical reference substances (CRS). The demand for a wide variety of CRS is critical, not only for common drugs like cocaine but also for the rapidly increasing number of new psychoactive substances (NPS), which emerge weekly. However, acquiring CRS is costly and bureaucratic because of the restricted circulation of these substances. Nuclear magnetic resonance (NMR) offers a viable alternative to identifying and quantifying substances without the need for specific CRS for each analyte. Although NMR equipment is commonly available at universities, it is typically absent from police laboratories because of its high initial cost. This work highlights a successful partnership between a forensic laboratory and university-based NMR facilities as a cost-effective strategy for obtaining CRS. A case study involving four substances-cocaine, two recently scheduled NPS, metonitazene and dipentylone, and ADB-5'Br-BUTINACA-demonstrates the effectiveness of this collaboration. This partnership allowed the generation of conclusive reports for seized substances, providing early warnings about NPS and helping to prevent potential outbreaks and public health crises. Additionally, the strategy facilitated the acquisition of expensive CRS from samples that would otherwise be destroyed, at a reduced cost and within a shorter timeframe. Furthermore, this partnership enhances student training in advanced instrumental analysis and research, showcasing the benefits of collaboration between forensic and academic institutions.
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Affiliation(s)
- Luciano Chaves Arantes
- Laboratory of Forensic Chemistry and Physics, Institute of Criminalistics, Civil Police of the Federal District, Brasília, Federal District, Brazil
| | - Dâmaris Silveira
- Pharmacy Department, Health Sciences School, University of Brasília, Brasília, Federal District, Brazil
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2
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Sharma AL, Tyagi P, Khumallambam M, Tyagi M. Cocaine-Induced DNA-Dependent Protein Kinase Relieves RNAP II Pausing by Promoting TRIM28 Phosphorylation and RNAP II Hyperphosphorylation to Enhance HIV Transcription. Cells 2024; 13:1950. [PMID: 39682697 DOI: 10.3390/cells13231950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2024] [Revised: 11/15/2024] [Accepted: 11/20/2024] [Indexed: 12/18/2024] Open
Abstract
Drug abuse continues to pose a significant challenge in HIV control efforts. In our investigation, we discovered that cocaine not only upregulates the expression of the DNA-dependent protein kinase (DNA-PK) but also augments DNA-PK activation by enhancing its phosphorylation at S2056. Moreover, DNA-PK phosphorylation triggers the higher localization of the DNA-PK into the nucleus. The finding that cocaine increases the nuclear localization of the DNA-PK provides further support to our observation of enhanced DNA-PK recruitment at the HIV long terminal repeat (LTR) following cocaine exposure. By activating and facilitating the nuclear localization of the DNA-PK, cocaine effectively orchestrates multiple stages of HIV transcription, thereby promoting HIV replication. Additionally, our study demonstrates that the cocaine-induced DNA-PK promotes the hyper-phosphorylation of the RNA polymerase II (RNAP II) carboxyl-terminal domain (CTD) at Ser5 and Ser2 sites, enhancing both the initiation and elongation phases, respectively, of HIV transcription. The cocaine-mediated enhancement of transcriptional initiation is supported by its activation of cyclin-dependent kinase 7 (CDK7). Additionally, the induction of transcriptional elongation is marked by higher LTR recruitment and the increased phosphorylation of CDK9, which indicates the stimulation of positive transcriptional elongation factor b (P-TEFb). We demonstrate for the first time that cocaine, through DNA-PK activation, promotes the specific phosphorylation of TRIM28 at serine 824 (p-TRIM28, S824). This modification converts TRIM28 from a transcriptional inhibitor to a transactivator for HIV transcription. Additionally, we observed that the phosphorylation of TRIM28 (p-TRIM28, S824) promotes the transition from the pausing phase to the elongation phase of HIV transcription, thereby facilitating the production of full-length HIV genomic transcripts. This finding corroborates the previously observed enhanced RNAP II CTD phosphorylation at Ser2, a marker of transcriptional elongation, following cocaine exposure. Accordingly, upon cocaine treatment, we observed the elevated recruitment of p-TRIM28-(S824) at the HIV LTR. Overall, our results unravel the intricate molecular mechanisms underlying cocaine-induced HIV transcription and gene expression. These findings hold promise for the development of highly targeted therapeutics aimed at mitigating the detrimental effects of cocaine in individuals living with HIV.
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Affiliation(s)
| | - Priya Tyagi
- Center for Translational Medicine, Thomas Jefferson University, 1020 Locust Street, Philadelphia, PA 19107, USA
| | - Meenata Khumallambam
- Center for Translational Medicine, Thomas Jefferson University, 1020 Locust Street, Philadelphia, PA 19107, USA
| | - Mudit Tyagi
- Center for Translational Medicine, Thomas Jefferson University, 1020 Locust Street, Philadelphia, PA 19107, USA
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3
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Garcia RCT, Spelta LEW, Udo MSB, Bruno V, Fonseca DA, de Faria Almeida CA, Dos Reis TM, Torres LH, Marcourakis T. Neurotoxicity of crack cocaine exposure: evidence from a systematic review of in vitro and in vivo studies. Arch Toxicol 2024; 98:2797-2816. [PMID: 38769171 DOI: 10.1007/s00204-024-03782-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 05/08/2024] [Indexed: 05/22/2024]
Abstract
Several studies suggest that crack cocaine users exhibit higher prevalence of both psychiatric and psychosocial problems, with an aggressive pattern of drug use. Nevertheless, few experimental studies attempted to verify the neurotoxicity after crack cocaine exposure, especially when compared with other routes of cocaine administration. This systematic review aimed to verify whether in vitro and/or in vivo crack cocaine exposure is more neurotoxic than cocaine exposure (snorted or injected). A search was performed in the PubMed, EMBASE, Scopus, Web of Science, and LILACS databases for in vitro and in vivo toxicological studies conducted with either rats or mice, with no distinction with regard to sex or age. Other methods including BioRxiv, BDTD, Academic Google, citation searching, and specialist consultation were also adopted. Two independent investigators screened the titles and abstracts of retrieved studies and subsequently performed full-text reading and data extraction. The quality of the included studies was assessed by the Toxicological data Reliability assessment Tool (ToxRTool). The study protocol was registered with the Prospective Registry of Systematic Reviews (PROSPERO; CRD42022332250). Of the twelve studies included, three were in vitro and nine were in vivo studies. According to the ToxRTool, most studies were considered reliable either with or without restrictions, with no one being considered as not reliable. The studies found neuroteratogenic effects, decreased threshold for epileptic seizures, schizophrenic-like symptoms, and cognitive deficits to be associated with crack cocaine exposure. Moreover, both in vitro and in vivo studies reported a worsening in cocaine neurotoxic effect caused by the anhydroecgonine methyl ester (AEME), a cocaine main pyrolysis product, which is in line with the more aggressive pattern of crack cocaine use. This systematic review suggests that crack cocaine exposure is more neurotoxic than other routes of cocaine administration. However, before the scarcity of studies on this topic, further toxicological studies are necessary.
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Affiliation(s)
- Raphael Caio Tamborelli Garcia
- Department of Pharmaceutical Sciences, Institute of Environmental, Chemical and Pharmaceutical Sciences, Universidade Federal de São Paulo, Diadema, São Paulo, Brazil.
| | - Lidia Emmanuela Wiazowski Spelta
- Department of Clinical and Toxicological Analysis, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
- Laboratory of Nuclear Medicine, Department of Radiology and Oncology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Mariana Sayuri Berto Udo
- Department of Clinical and Toxicological Analysis, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
- Department of Neurology, McGovern Medical School, University of Texas Health at Houston, Houston, TX, USA
| | - Vitor Bruno
- Department of Clinical and Toxicological Analysis, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Danilo Aguiar Fonseca
- Department of Pharmaceutical Sciences, Institute of Environmental, Chemical and Pharmaceutical Sciences, Universidade Federal de São Paulo, Diadema, São Paulo, Brazil
| | | | - Tiago Marques Dos Reis
- Department of Clinical and Toxicological Analysis, Faculty of Pharmaceutical Sciences, Federal University of Alfenas, Alfenas, Minas Gerais, Brazil
| | - Larissa Helena Torres
- Department of Neurology, McGovern Medical School, University of Texas Health at Houston, Houston, TX, USA
| | - Tania Marcourakis
- Department of Clinical and Toxicological Analysis, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil.
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4
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Sharma AL, Tyagi P, Khumallambam M, Tyagi M. Cocaine-induced DNA-PK relieves RNAP II pausing by promoting TRIM28 phosphorylation. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.08.19.608673. [PMID: 39229050 PMCID: PMC11370412 DOI: 10.1101/2024.08.19.608673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 09/05/2024]
Abstract
Drug abuse continues to pose a significant challenge in HIV control efforts. In our investigation, we discovered that cocaine not only upregulates the expression of DNA-dependent protein kinase (DNA-PK) but also augments DNA-PK activation by enhancing its phosphorylation at S2056. Moreover, DNA-PK phosphorylation triggers the translocation of DNA-PK into the nucleus. The finding that cocaine promotes nuclear translocation of DNA-PK further validates our observation of enhanced DNA-PK recruitment at the HIV long terminal repeat (LTR) following cocaine exposure. By activating and facilitating the nuclear translocation of DNA-PK, cocaine effectively orchestrates multiple stages of HIV transcription, thereby promoting HIV replication. Additionally, our study indicates that cocaine-induced DNA-PK promotes hyper-phosphorylation of RNA polymerase II (RNAP II) carboxyl-terminal domain (CTD) at Ser5 and Ser2 sites, enhancing both initiation and elongation phases, respectively, of HIV transcription. Cocaine's enhancement of transcription initiation and elongation is further supported by its activation of cyclin-dependent kinase 7 (CDK7) and subsequent phosphorylation of CDK9, thereby promoting positive transcriptional elongation factor b (P-TEFb) activity. We demonstrate for the first time that cocaine, through DNA-PK activation, promotes the specific phosphorylation of TRIM28 at Serine 824 (p-TRIM28, S824). This modification converts TRIM28 from a transcriptional inhibitor to a transactivator for HIV transcription. Additionally, we observe that phosphorylation of TRIM28 (p-TRIM28, S824) promotes the transition from the pausing phase to the elongation phase of HIV transcription, thereby facilitating the production of full-length HIV genomic transcripts. This finding corroborates the observed enhanced RNAP II CTD phosphorylation at Ser2, a marker of transcriptional elongation, following cocaine exposure. Accordingly, upon cocaine treatment, we observed elevated recruitment of p-TRIM28-(S824) at the HIV LTR. Overall, our results have unraveled the intricate molecular mechanisms underlying cocaine-induced HIV transcription and gene expression. These findings hold promise for the development of highly targeted therapeutics aimed at mitigating the detrimental effects of cocaine in individuals living with HIV.
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Affiliation(s)
| | - Priya Tyagi
- Center for Translational Medicine, Thomas Jefferson University, 1020 Locust Street, Philadelphia, PA 19107, USA
| | - Meenata Khumallambam
- Center for Translational Medicine, Thomas Jefferson University, 1020 Locust Street, Philadelphia, PA 19107, USA
| | - Mudit Tyagi
- Center for Translational Medicine, Thomas Jefferson University, 1020 Locust Street, Philadelphia, PA 19107, USA
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5
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Lutfallah SC, Brown E, Spillers NJ, Tandon A, Kelkar RA, Ahmadzadeh S, Viswanath O, Varrassi G, Shekoohi S, Kaye AD. Topical Cocaine Hydrochloride Nasal Solution: Anesthetic and Surgical Considerations. Cureus 2023; 15:e42804. [PMID: 37664274 PMCID: PMC10470476 DOI: 10.7759/cureus.42804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 08/01/2023] [Indexed: 09/05/2023] Open
Abstract
Adequate surgical view during various types of nasal procedures is essential for surgical operations to be performed in a safe, efficient, and successful manner. Minimizing bleeding during surgery is an important way of increasing visualization that is commonly achieved by using a vasoconstrictive agent to control intraoperative hemorrhage. Many otolaryngologists choose to employ topical cocaine to minimize bleeding during surgery owing to its vasoconstrictive properties, while simultaneously benefitting from its dual local anesthetic effects. The relative benefit of topical cocaine for otolaryngologic procedures when compared to other topical analgesics and vasoconstrictors remains a topic of discussion due to the multiple potential cardiac and central nervous system side effects associated with cocaine administration. Furthermore, there is not a scientifically backed maximal safe dose published; instead, most of the guidelines for intranasal cocaine use are based on untested clinical practice. Despite this, the short latency, adequate duration of action, and inherent vasoconstrictive and decongestive capabilities make cocaine a valuable anesthetic agent for use in clinical procedures. As the relative benefit of using topical cocaine compared to the use of other vasoconstrictors and analgesics for nasal procedures remains undetermined in the current literature, this leaves the need for a comprehensive review of research that explores the risks and benefits of using topical cocaine in nasal procedures based on clinical trials that compare intranasal cocaine with various other analgesics and vasoconstrictors.
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Affiliation(s)
- Salim C Lutfallah
- School of Medicine, Louisiana State University Health Sciences Center at New Orleans, New Orleans, USA
| | - Elise Brown
- School of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, USA
| | - Noah J Spillers
- School of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, USA
| | - Anamika Tandon
- School of Medicine, Louisiana State University Health Sciences Center at New Orleans, New Orleans, USA
| | - Rucha A Kelkar
- School of Medicine, Medical University of South Carolina, Charleston, USA
| | - Shahab Ahmadzadeh
- Anesthesiology, Louisiana State University Health Sciences Center, Shreveport, USA
| | - Omar Viswanath
- Pain Management, Valley Pain Consultants - Envision Physician Services, Phoenix, USA
| | | | - Sahar Shekoohi
- Anesthesiology, Louisiana State University Health Sciences Center, Shreveport, USA
| | - Alan D Kaye
- Anesthesiology, Louisiana State University Health Sciences Center, Shreveport, USA
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6
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Yeh K, Li L, Wania F, Abbatt JPD. Thirdhand smoke from tobacco, e-cigarettes, cannabis, methamphetamine and cocaine: Partitioning, reactive fate, and human exposure in indoor environments. ENVIRONMENT INTERNATIONAL 2022; 160:107063. [PMID: 34954646 DOI: 10.1016/j.envint.2021.107063] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 12/19/2021] [Accepted: 12/21/2021] [Indexed: 06/14/2023]
Abstract
A source of chemical exposure to humans, thirdhand smoke (THS) refers to the contamination that persists indoors following the cessation of a smoking event. The composition of thirdhand smoke depends on the type of substance from which it originates. Although past studies have investigated the effects of tobacco THS on indoor air quality and human health, few have focused on the chemical composition and health impacts of other sources and components of THS. Here we review the state of knowledge of the composition and partitioning behavior of various types of indoor THS, with a focus on THS from tobacco, e-cigarettes, cannabis, and illicit substances (methamphetamine and cocaine). The discussion is supplemented by estimates of human exposure to THS components made with a chemical fate and exposure model. The modeling results show that while very volatile THS compounds (i.e., aromatics) are likely to be taken up by inhalation, highly water-soluble compounds tended to be dermally absorbed. Conversely, minimally volatile THS compounds with low solubility are predicted to be ingested through hand-to-mouth and object-to-mouth contact.
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Affiliation(s)
- Kristen Yeh
- Department of Chemistry, University of Toronto, 80 St. George Street, Toronto, ON M5S 3H6, Canada.
| | - Li Li
- School of Public Health, University of Nevada Reno, Reno, NV 89557, United States
| | - Frank Wania
- Department of Physical and Environmental Sciences, University of Toronto Scarborough, 1265 Military Trail, Toronto, Ontario M1C 1A4, Canada
| | - Jonathan P D Abbatt
- Department of Chemistry, University of Toronto, 80 St. George Street, Toronto, ON M5S 3H6, Canada
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7
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Klausen MK, Thomsen M, Wortwein G, Fink-Jensen A. The role of glucagon-like peptide 1 (GLP-1) in addictive disorders. Br J Pharmacol 2021; 179:625-641. [PMID: 34532853 DOI: 10.1111/bph.15677] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 05/21/2021] [Accepted: 06/19/2021] [Indexed: 11/29/2022] Open
Abstract
Drug-, alcohol- and tobacco use disorders are a global burden affecting millions of people. Despite decades of research, treatment options are sparse or missing, and relapse rates are high. Glucagon-like peptide-1 (GLP-1) is released in the small intestines, promotes blood glucose homeostasis, slows gastric emptying, and reduces appetite. GLP-1 receptor agonists approved for treating type 2 diabetes mellitus and obesity, have received attention as a potential anti-addiction treatment. Studies in rodents and non-human primates have demonstrated a reduction in intake of alcohol and drugs of abuse, and clinical trials have been initiated to investigate whether the preclinical findings can be translated to patients. This review will give an overview of current findings and discuss the possible mechanisms of action. We suggest that effects of GLP-1 in alcohol- and substance use disorder is mediated centrally, at least partly through dopamine signalling, but precise mechanisms are still to be uncovered.
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Affiliation(s)
- Mette Kruse Klausen
- Psychiatric Centre Copenhagen and University Hospital of Copenhagen, Copenhagen, Denmark
| | - Morgane Thomsen
- Laboratory of Neuropsychiatry, Psychiatric Centre Copenhagen and University Hospital of Copenhagen, Copenhagen, Denmark
| | - Gitta Wortwein
- Laboratory of Neuropsychiatry, Psychiatric Centre Copenhagen and University Hospital of Copenhagen, Copenhagen, Denmark
| | - Anders Fink-Jensen
- Laboratory of Neuropsychiatry, Psychiatric Centre Copenhagen and University Hospital of Copenhagen, Copenhagen, Denmark
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8
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Abstract
Sympathomimetic drugs comprise a broad category of substances including both illicit and prescribed drugs that have deleterious effects when ingested or abused. The clinical syndromes that result from overstimulation of the sympathetic nervous system by reuptake inhibition of biogenic amines, such as norepinephrine and dopamine, carry significant morbidity. Recognition and awareness of the appropriate supportive measures are required to mitigate life-threatening complications of multiple organ systems. The sympathomimetic toxidrome is recognized by a constellation of symptoms including agitation, hyperthermia, tachycardia, and hypertension, and the primary treatment involves supportive care, including the liberal use of benzodiazepines.
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Affiliation(s)
- Hallie Brown
- Department of Emergency Medicine, Indiana University School of Medicine, 720 Eskenazi Avenue, Fifth Third Bank Building - Third Floor, Indianapolis, IN 46202, USA
| | - Katherine A Pollard
- Department of Emergency Medicine, Indiana University School of Medicine, 720 Eskenazi Avenue, Fifth Third Bank Building - Third Floor, Indianapolis, IN 46202, USA; Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
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9
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Affiliation(s)
- David C Sheridan
- Department of Emergency Medicine, Oregon Health & Science University, Portland, OR
| | - Adrienne Hughes
- Department of Emergency Medicine, Oregon Health & Science University, Portland, OR.,Oregon Poison Center, Portland, OR
| | - B Zane Horowitz
- Department of Emergency Medicine, Oregon Health & Science University, Portland, OR.,Oregon Poison Center, Portland, OR
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10
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Waldman W, Kabata PM, Dines AM, Wood DM, Yates C, Heyerdahl F, Hovda KE, Giraudon I, Dargan PI, Sein Anand J. Rhabdomyolysis related to acute recreational drug toxicity-A Euro-DEN study. PLoS One 2021; 16:e0246297. [PMID: 33705425 PMCID: PMC7951866 DOI: 10.1371/journal.pone.0246297] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 01/17/2021] [Indexed: 11/17/2022] Open
Abstract
Background This study was conducted to retrospectively assess the relationships between: rhabdomyolysis (quantified by creatine kinase (CK) activity) and kidney injury (quantified by serum creatinine concentration), sex, age, body temperature on admission, presence of seizures, and agitation or aggression in patients presenting to the Emergency Department with acute recreational drug toxicity. We also investigated the association with the substances ingested. Methods All presentations to the 16 sentinel Euro-DEN centres in 10 European countries with acute recreational drug toxicity during the first year of the Euro-DEN study (October 2013 to September 2014) were considered. Cases that had abnormal CK activity recorded as part of routine clinical care were divided into 3 cohorts depending on peak CK activity. Cases with normal CK activity were included as a control group (4th cohort). Results Only 1,015 (18.4%) of the 5,529 Euro-DEN presentations had CK activity concentration recorded. Of this group 353 (34.8%) had also creatinine concentration measured. There were 375 (36.9%) with minor rhabdomyolysis, 69 (6.8%) with moderate rhabdomyolysis, and 24 (2.4%) with severe rhabdomyolysis; 547 (53.9%) were included in the control group. There was a positive correlation between CK activity and creatinine concentration (correlation coefficient r = 0.71, p<0.0001). There was no correlation between CK activity and body temperature at the time of presentation to the ED (correlation coefficient r = 0.07, p = 0.03). There was a positive correlation between CK activity and length of stay in the hospital (r = 0.31, p<0.001). There was no association between CK activity and the presence of seizures (p = 0.33) or agitation/aggression (p = 0.45), patients age (p = 0.4) or sex (p = 0.25). The 5 most common agents amongst patients presenting with rhabdomyolysis were: cocaine (n = 107; 22.9% presentations), amphetamine (76; 16.2%), cannabis (74; 15.8%), GHB/GBL (72; 15.4%) and heroin (67; 14.3%). The distribution of rhabdomyolysis in 5 most common drugs was (drug; patients with rhabdomyolysis, patients without rhabdomyolysis): cocaine (107, 122), cannabis (74, 117), GHB/GBL (72, 81), amphetamine (76, 66), heroin (67, 70). Conclusions Abnormal values of CK activity occurred in almost half (46.1%) of presentations to the Emergency Department with acute recreational drug toxicity in whom CK activity was measured; however, severe rhabdomyolysis is seen in only a small minority (2.4%). Those with rhabdomyolysis are at significantly higher risk of kidney injury and have a longer length of hospital stay.
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Affiliation(s)
- Wojciech Waldman
- Department of Clinical Toxicology, Medical University of Gdansk, Gdansk, Poland.,Pomeranian Centre of Toxicology, Gdansk, Poland
| | | | - Alison M Dines
- Clinical Toxicology, Guy's and St Thomas' NHS Foundation Trust and King's Health Partners, London, United Kingdom
| | - David M Wood
- Clinical Toxicology, Guy's and St Thomas' NHS Foundation Trust and King's Health Partners, London, United Kingdom.,Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | | | | | | | - Isabelle Giraudon
- European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Lisbon, Portugal
| | | | - Paul I Dargan
- Clinical Toxicology, Guy's and St Thomas' NHS Foundation Trust and King's Health Partners, London, United Kingdom.,Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Jacek Sein Anand
- Department of Clinical Toxicology, Medical University of Gdansk, Gdansk, Poland.,Pomeranian Centre of Toxicology, Gdansk, Poland
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11
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Chen DH, Kolossváry M, Chen S, Lai H, Yeh HC, Lai S. Long-term cocaine use is associated with increased coronary plaque burden - a pilot study. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2020; 46:805-811. [PMID: 32990047 DOI: 10.1080/00952990.2020.1807558] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Background: There is a lack of research regarding whether prolonged use of cocaine would lead to increase of coronary plaque burden. Objectives: To study the effects of cocaine use on the coronary artery plaque volume. We hypothesize the longer the cocaine use, the greater the plaque burden. Methods: We used coronary computed tomography angiography to evaluate plaque volumes. The study included chronic (N = 33 with 27 HIV+) and non-cocaine users (N = 15 with 12 HIV+). Chronic cocaine use was defined as use by any route for at least 6 months, administered at least 4 times/month. The Student's t-test was used to compare the plaque volumes between chronic and non-cocaine users. Multivariable regression analysis adjusted for age, sex, body mass index, HIV status, cigarette smoking, diabetes, and total cholesterol was performed to determine the relationship between years of cocaine use and plaque volumes. Results: The total plaque volumes between groups showed no difference (p = .065). However, the total left anterior descending artery (LAD) plaque volume in the chronic cocaine group was significantly higher than that in the non-cocaine group (p = .047). For each year increase in cocaine use, total plaque volume and total LAD plaque volume increased by 7.23 mm3 (p = .013) and 4.56 mm3 (p = .001), respectively. In the multivariable analyses, both total plaque volume and total LAD plaque volume were significantly associated with years of cocaine use (p = .039 and 0.013, respectively). Conclusion: Prolonged cocaine use accelerates the development of sub-clinical atherosclerosis.
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Affiliation(s)
- Doris Hsinyu Chen
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health , Baltimore, USA
| | - Márton Kolossváry
- Department of Pathology, Johns Hopkins School of Medicine , Baltimore, USA.,MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University , Budapest, Hungary
| | - Shaoguang Chen
- Department of Pathology, Johns Hopkins School of Medicine , Baltimore, USA.,Institute of Human Virology, University of Maryland School of Medicine, University of Maryland School of Medicine , Baltimore, USA
| | - Hong Lai
- Department of Pathology, Johns Hopkins School of Medicine , Baltimore, USA.,Institute of Human Virology, University of Maryland School of Medicine, University of Maryland School of Medicine , Baltimore, USA
| | - Hsin-Chieh Yeh
- Division of General Internal Medicine, Johns Hopkins School of Medicine , Baltimore, USA
| | - Shenghan Lai
- Department of Pathology, Johns Hopkins School of Medicine , Baltimore, USA.,Institute of Human Virology, University of Maryland School of Medicine, University of Maryland School of Medicine , Baltimore, USA
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12
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St. John AL, Choi HW, Walker QD, Blough B, Kuhn CM, Abraham SN, Staats HF. Novel mucosal adjuvant, mastoparan-7, improves cocaine vaccine efficacy. NPJ Vaccines 2020; 5:12. [PMID: 32047657 PMCID: PMC7002721 DOI: 10.1038/s41541-020-0161-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 01/14/2020] [Indexed: 12/29/2022] Open
Abstract
Cocaine is one of the most potent and addictive psychostimulants known and there are no available pharmacotherapies to treat cocaine addiction. Here we describe a novel cocaine vaccine employing the mucosal adjuvant and mast cell-activating oligopeptide, mastoparan-7 (M7), to achieve optimal IgA antibody responses in mucosal secretions and effective induction of humoral immunity using a short immunization protocol. This formulation, using a hapten-carrier system to deliver cocaine as antigen, also reduced cocaine penetration of the blood brain barrier and protected mice from its psychoactive effects by reducing cocaine-induced locomotion. Surprisingly, the magnitude of cocaine-specific antibody titers induced by each adjuvant was not the major determinant of functional protection from cocaine challenge. A side-by-side comparison of the two haptens, cocaine and its analog GNC demonstrated that cocaine haptenation resulted in superior functional protection when used in combination with the novel mucosal adjuvant, M7. These results provide a new potential strategy for combatting cocaine addiction through mucosal vaccination.
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Affiliation(s)
- Ashley L. St. John
- Program in Emerging Infectious Diseases, Duke-National University of Singapore, Singapore, 169857 Singapore
- Department of Pathology, Duke University Medical Center, Durham, NC 27710 USA
- Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228 Singapore
- SingHealth Duke-NUS Global Health Institute, Singapore, 168753 Singapore
| | - Hae Woong Choi
- Department of Pathology, Duke University Medical Center, Durham, NC 27710 USA
- Present Address: Korea University, Division of Life Sciences, 108 Hana-Science Building, 145 Anam-ro, Seongbuk-gu, Seoul, South Korea
| | - Q. David Walker
- Department of Pharmacology and Cancer Biology, Duke University Medical Center, Durham, NC 27710 USA
| | - Bruce Blough
- Center for Drug Discovery, RTI International, Research Triangle Park, Durham, NC 27709 USA
| | - Cynthia M. Kuhn
- Department of Pharmacology and Cancer Biology, Duke University Medical Center, Durham, NC 27710 USA
| | - Soman N. Abraham
- Program in Emerging Infectious Diseases, Duke-National University of Singapore, Singapore, 169857 Singapore
- Department of Pathology, Duke University Medical Center, Durham, NC 27710 USA
- Department of Immunology, Duke University Medical Center, Durham, NC 27710 USA
- Department of Molecular Genetics and Microbiology, Duke University Medical Center, Durham, NC 27710 USA
| | - Herman F. Staats
- Department of Pathology, Duke University Medical Center, Durham, NC 27710 USA
- Department of Pharmacology and Cancer Biology, Duke University Medical Center, Durham, NC 27710 USA
- Duke Human Vaccine Institute, Duke University Medical Center, Durham, NC 27710 USA
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13
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Zhou CY, Ricker M, Pathak V. Cocaine-Induced Bronchospasm Mimicking Acute Asthma Exacerbation. Clin Med Res 2019; 17:34-36. [PMID: 31160477 PMCID: PMC6546277 DOI: 10.3121/cmr.2019.1447] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 11/14/2018] [Accepted: 11/20/2018] [Indexed: 11/18/2022]
Abstract
Cocaine can cause a myriad of changes in the lung, which can range from bronchoconstriction to destruction of the alveolar-capillary membrane and acute lung injury. Cocaine-induced bronchospasm is a diagnosis of exclusion that should be considered when the clinical presentation of acute hypoxic and hypercapneic respiratory failure cannot be explained by chronic obstructive pulmonary disease or asthma exacerbation, anaphylaxis to food or medications, exercise, or infection. Here, we present two patients with acute hypoxic and hypercapneic respiratory failure that was ultimately attributed to cocaine use shortly prior to symptom onset.
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Affiliation(s)
- Christine Y Zhou
- Department of Medicine, Campbell University School of Osteopathic Medicine, Lillington, North Carolina, USA
| | - Melissa Ricker
- Department of Pulmonary and Critical Care, Atrium Health, Charlotte, North Carolina, USA
| | - Vikas Pathak
- Department of Pulmonary and Critical Care, WakeMed Hospitals and Health System, Raleigh, North Carolina, USA
- Department of Medicine, Campbell University School of Osteopathic Medicine, Lillington, North Carolina, USA
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14
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Bravo-Gómez ME, Camacho-García LN, Castillo-Alanís LA, Mendoza-Meléndez MÁ, Quijano-Mateos A. Revisiting a physiologically based pharmacokinetic model for cocaine with a forensic scope. Toxicol Res (Camb) 2019; 8:432-446. [PMID: 31160976 PMCID: PMC6505388 DOI: 10.1039/c8tx00309b] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Accepted: 02/11/2019] [Indexed: 11/21/2022] Open
Abstract
A whole-body permeability-rate-limited physiologically based pharmacokinetic (PBPK) model for cocaine was developed and adjusted with the pharmacokinetic data from studies with animals and reparametrized scaling to humans with the aim to predict the concentration-time profiles of the drug in blood and different tissues in humans. Estimated time course concentrations could be used as an interpretation tool by forensic toxicologists. The model estimations were compared successfully with pharmacokinetic parameters and time to peak for some effects reported in the literature. Once developed, the PBPK model was employed to predict the time course tissue concentrations reported in previous distribution studies introducing individualizing data. The heart and brain concentrations estimated by the model match adequately with the time and duration of some effects such as chronotropic and psychoactive effects, respectively. This work is the first attempt for employing PBPK modeling as a tool for forensic interpretation. Future modeling of other cocaine metabolite profiles or interaction when co-administered with other substances, such as alcohol, might be developed in the future.
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Affiliation(s)
- María Elena Bravo-Gómez
- Forensic Science Department , School of Medicine , National Autonomous University of Mexico , Av. Universidad 3000 , ZC 04510 , Mexico City , Mexico . ; ; ; Tel: +52-(55)56232300 Ext.81916
| | - Laura Nayeli Camacho-García
- School of Chemistry , National Autonomous University of Mexico , Av. Universidad 3000 , ZC 04510 , Mexico City , Mexico .
| | - Luz Alejandra Castillo-Alanís
- Forensic Science Department , School of Medicine , National Autonomous University of Mexico , Av. Universidad 3000 , ZC 04510 , Mexico City , Mexico . ; ; ; Tel: +52-(55)56232300 Ext.81916
| | - Miguel Ángel Mendoza-Meléndez
- Research and Advanced Studies Centre , Politechnical National Institute (CINVESTAV-IPN). Av. Instituto Politécnico Nacional 2508 , Col. San Pedro Zacatenco , Gustavo A. Madero , ZC 07360 , Mexico City , Mexico .
| | - Alejandra Quijano-Mateos
- Forensic Science Department , School of Medicine , National Autonomous University of Mexico , Av. Universidad 3000 , ZC 04510 , Mexico City , Mexico . ; ; ; Tel: +52-(55)56232300 Ext.81916
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15
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Abstract
Drug use and the associated overdose deaths have been a serious public health threat in the United States and the world. While traditional drugs of abuse such as cocaine remain popular, recreational use of newer synthetic drugs has continued to increase, but the prevalence of use is likely underestimated. In this review, epidemiology, chemistry, pharmacophysiology, clinical effects, laboratory detection, and clinical treatment are discussed for newly emerging drugs of abuse in the following classes: (1) opioids (e.g., fentanyl, fentanyl analogues, and mitragynine), (2) cannabinoids [THC and its analogues, alkylindole (e.g., JWH-018, JWH-073), cyclohexylphenol (e.g., CP-47,497), and indazole carboxamide (e.g., FUB-AMB, ADB-FUBINACA)], (3) stimulants and hallucinogens [β-keto amphetamines (e.g., methcathinone, methylone), pyrrolidinophenones (e.g., α-PVP, MDPV), and dimethoxyphenethylamine ("2C" and "NBOMe")], (4) dissociative agents (e.g., 3-MeO-PCP, methoxetamine, 2-oxo-PCE), and (5) sedative-hypnotics (e.g., gabapentin, baclofen, clonazolam, etizolam). It is critically important to coordinate hospital, medical examiner, and law enforcement personnel with laboratory services to respond to these emerging threats.
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Affiliation(s)
- Kenichi Tamama
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. .,Clinical Laboratories, University of Pittsburgh Medical Center Presbyterian Hospital, Pittsburgh, PA, USA. .,McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA. .,Clinical Laboratory, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA.
| | - Michael J Lynch
- Division of Medical Toxicology, Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. .,Pittsburgh Poison Center, Pittsburgh, PA, USA.
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16
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de Coo IF, Naber WC, Wilbrink LA, Haan J, Ferrari MD, Fronczek R. Increased use of illicit drugs in a Dutch cluster headache population. Cephalalgia 2018; 39:626-634. [PMID: 30290701 PMCID: PMC6484703 DOI: 10.1177/0333102418804160] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Introduction Many patients with cluster headache report use of illicit drugs. We systematically assessed the use of illicit drugs and their effects in a well-defined Dutch cluster headache population. Methods In this cross-sectional explorative study, 756 people with cluster headache received a questionnaire on lifetime use and perceived effects of illicit drugs. Results were compared with age and sex-matched official data from the Dutch general population. Results Compared to the data from the general population, there were more illicit drug users in the cluster headache group (31.7% vs. 23.8%; p < 0.01). Reduction in attack frequency was reported by 56% (n = 22) of psilocybin mushroom, 60% (n = 3) of lysergic acid diethylamide and 50% (n = 2) of heroin users, and a decreased attack duration was reported by 46% (n = 18) of PSI, 50% (n = 2) of heroin and 36% (n = 8) of amphetamine users. Conclusion In the Netherlands, people with cluster headache use illicit drugs more often than the general population. The question remains whether this is due to an actual alleviatory effect, placebo response, conviction, or common pathophysiological background between cluster headache and addictive behaviours such as drug use.
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Affiliation(s)
- Ilse F de Coo
- 1 Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands.,2 Sophia Rehabilitation Center, the Hague, the Netherlands
| | - Willemijn C Naber
- 1 Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands
| | - Leopoldine A Wilbrink
- 1 Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands
| | - Joost Haan
- 1 Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands.,3 Department of Neurology, Alrijne Hospital, Leiderdorp, the Netherlands
| | - Michel D Ferrari
- 1 Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands
| | - Rolf Fronczek
- 1 Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands.,4 Slaap-Waakcentrum SEIN, Heemstede, the Netherlands
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17
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Oliveira NG, Dinis-Oliveira RJ. Drugs of abuse from a different toxicological perspective: an updated review of cocaine genotoxicity. Arch Toxicol 2018; 92:2987-3006. [PMID: 30116851 DOI: 10.1007/s00204-018-2281-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 08/02/2018] [Indexed: 01/17/2023]
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18
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Wolf J, Narkiewicz K. Managing comorbid cardiovascular disease and sleep apnea with pharmacotherapy. Expert Opin Pharmacother 2018; 19:961-969. [PMID: 29792524 DOI: 10.1080/14656566.2018.1476489] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Highly prevalent sleep disordered breathing (SDB) has been recognized as an independent cardiovascular disease (CVD) risk factor. Although these two entities often coexist, there is a shortage of sufficiently-powered studies testing the interplay between the course of sleep apnea and CVD pharmacotherapy. The mutual relationship between treated/untreated obstructive sleep apnea (OSA) with ongoing cardiovascular pharmacotherapies is an evident gap in clinical expertise. AREAS COVERED In this article, the authors review the available evidence and outline future research directions concerning the reciprocal relationship between the pharmacological treatment of CVD and SDB. Several attempts have been made to identify the most efficacious hypotensive agents for patients with both OSA and hypertension. Various cardiovascular drugs are also evaluated in terms of their influence on sleep apnea severity. EXPERT OPINION The question of whether OSA should be included in cardiovascular pharmacotherapy individualization algorithms is a matter of debate and more evidence is needed. Cautious intensification of diuretics with the use of aldosterone receptor antagonists deserves attention when both high blood pressure and sleep apnea coexist.
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Affiliation(s)
- Jacek Wolf
- a Faculty of Medicine, Department of Hypertension and Diabetology , Medical University of Gdańsk , Gdańsk , Poland
| | - Krzysztof Narkiewicz
- a Faculty of Medicine, Department of Hypertension and Diabetology , Medical University of Gdańsk , Gdańsk , Poland
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19
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Wavenumber selection method to determine the concentration of cocaine and adulterants in cocaine samples. J Pharm Biomed Anal 2018; 152:120-127. [DOI: 10.1016/j.jpba.2018.01.050] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 01/23/2018] [Accepted: 01/24/2018] [Indexed: 11/15/2022]
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20
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Nienhuis K, Van Hoof JJ, Van der Lely N. Direct Clinical Health Effects of the Consumption of Alcohol Mixed With Energy Drink in Dutch Adolescents. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2018. [DOI: 10.1080/1067828x.2018.1424669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Karin Nienhuis
- Department of Pediatrics, Reinier de Graaf Gasthuis, Delft, Netherlands
| | - Joris J. Van Hoof
- Faculty of Behavioral, Management and Social Sciences, University of Twente, Enschede, Netherlands
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21
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Knuth M, Temme O, Daldrup T, Pawlik E. Analysis of cocaine adulterants in human brain in cases of drug-related death. Forensic Sci Int 2018; 285:86-92. [PMID: 29454838 DOI: 10.1016/j.forsciint.2018.02.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 01/29/2018] [Accepted: 02/03/2018] [Indexed: 11/29/2022]
Abstract
For different reasons, street cocaine is often diluted with pharmacologically active substances, the so-called adulterants such as levamisole or hydroxyzine. A controversial debate exists currently on the uptake of adulterants from cocaine preparations and drug-related death. Previous research convincingly argues that serious adverse side effects that affect the central nervous and cardiovascular systems can be a consequence of adulterated cocaine. AIMS Having identified the presence of adulterants in lung tissue and blood, the concentrations of these substances in brain, an important target location, was of interest. This provides an opportunity to assess their role in cases of drug-related deaths. MATERIALS AND METHODS We developed and validated a method for the analysis of cocaine, two cocaine metabolites and six adulterants, which can typically be found in cocaine preparations, and one adulterant metabolite in brain tissue by gas chromatography-mass spectrometry (GC-MS)1. Ten brain samples which were tested positive for cocaine were analyzed. The homogenized brain tissue was embedded into drying paper for protein precipitation. During a subsequent solid-phase extraction (SPE), the eluate and one of the wash fractions were collected. After derivatization with N-Methyl-N-(trimethylsilyl)trifluoroacetamide (MSTFA) in pyridine and isooctane, the extracts were analyzed by GC-MS. RESULTS AND DISCUSSION The method was fully validated for cocaine (COC), benzoylecgonine (BZE), ecgonine methyl ester (EME), diltiazem (DIL), hydroxyzine (HYD), and levamisole (LEV) and partly validated for cetirizine (CET), lidocaine (LID), phenacetin (PHE), and procaine (PRO) in brain material. By analyzing post-mortem brain tissue of ten cocaine users, LEV, LID, and HYD as well as PHE were identified in contrast to DIL, PRO, and the HYD metabolite CET. HYD and LEV were found in moderate to high concentrations in some cases. Therefore, it cannot be excluded that they have caused adverse side effects. CONCLUSION Because adulterants can potentially affect the central nervous and cardiac systems, it is likely that they enhance COC toxicity.
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Affiliation(s)
- Marianne Knuth
- Institute of Legal Medicine, University Hospital Duesseldorf, Moorenstraße 5, 40225 Duesseldorf, Germany.
| | - Oliver Temme
- Institute of Legal Medicine, University Hospital Duesseldorf, Moorenstraße 5, 40225 Duesseldorf, Germany
| | - Thomas Daldrup
- Institute of Legal Medicine, University Hospital Duesseldorf, Moorenstraße 5, 40225 Duesseldorf, Germany
| | - Evelyn Pawlik
- Institute of Legal Medicine, University Hospital Duesseldorf, Moorenstraße 5, 40225 Duesseldorf, Germany
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22
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Identification of biochemical and cytotoxic markers in cocaine treated PC12 cells. Sci Rep 2018; 8:2710. [PMID: 29426863 PMCID: PMC5807423 DOI: 10.1038/s41598-018-21182-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 01/30/2018] [Indexed: 12/24/2022] Open
Abstract
Cocaine is one of the powerful addictive drugs, widely abused in most Western countries. Because of high lipophilic nature, cocaine easily reaches various domains of the central nervous system (CNS) and triggers different levels of cellular toxicity. The aim of this investigation was to reproduce cocaine toxicity in differentiated PC12 cells through quantitative knowledge on biochemical and cytotoxicity markers. We differentiated the cells with 0.1 μg/ml nerve growth factor (NGF) for 5 days, followed by treatment with cocaine for 48 h at in vivo and in vitro concentrations. Results indicated that cocaine at in vivo concentrations neither killed the cells nor altered the morphology, but decreased the mitochondrial membrane potential that paralleled with increased lactate and glutathione (GSH) levels. On the other hand, cocaine at in vitro concentrations damaged the neurites and caused cell death, which corresponded with increased reactive oxygen species (ROS) generation, plasma membrane damage, and GSH depletion with no detectable nitric oxide (NO) level. While direct understanding of cocaine and cell interaction under in vivo animal models is impeded due to high complexity, our present in vitro results assisted in understanding the onset of some key events of neurodegenerative diseases in cocaine treated neuronal cells.
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23
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Kudlacek O, Hofmaier T, Luf A, Mayer FP, Stockner T, Nagy C, Holy M, Freissmuth M, Schmid R, Sitte HH. Cocaine adulteration. J Chem Neuroanat 2017; 83-84:75-81. [PMID: 28619473 PMCID: PMC7610562 DOI: 10.1016/j.jchemneu.2017.06.001] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 05/03/2017] [Accepted: 06/10/2017] [Indexed: 12/20/2022]
Abstract
Cocaine is a naturally occurring and illicitly used psychostimulant drug. Cocaine acts at monoaminergic neurotransmitter transporters to block uptake of the monoamines, dopamine, serotonin and norepinephrine. The resulting increase of monoamines in the extracellular space underlies the positively reinforcing effects that cocaine users seek. In turn, this increase in monoamines underlies the development of addiction, and can also result in a number of severe side effects. Currently, cocaine is one of the most common illicit drugs available on the European market. However, cocaine is increasingly sold in impure forms. This trend is driven by cocaine dealers seeking to increase their profit margin by mixing ("cutting") cocaine with numerous other compounds ("adulterants"). Importantly, these undeclared compounds put cocaine consumers at risk, because consumers are not aware of the additional potential threats to their health. This review describes adulterants that have been identified in cocaine sold on the street market. Their typical pharmacological profile and possible reasons why these compounds can be used as cutting agents will be discussed. Since a subset of these adulterants has been found to exert effects similar to cocaine itself, we will discuss levamisole, the most frequently used cocaine cutting agent today, and its metabolite aminorex.
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Affiliation(s)
- Oliver Kudlacek
- Medical University Vienna, Center for Physiology and Pharmacology, Institute of Pharmacology, Waehringerstrasse 13a, 1090 Vienna, Austria
| | - Tina Hofmaier
- Medical University Vienna, Center for Physiology and Pharmacology, Institute of Pharmacology, Waehringerstrasse 13a, 1090 Vienna, Austria
| | - Anton Luf
- Medical University of Vienna, Clinical Department of Laboratory Medicine, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Felix P Mayer
- Medical University Vienna, Center for Physiology and Pharmacology, Institute of Pharmacology, Waehringerstrasse 13a, 1090 Vienna, Austria
| | - Thomas Stockner
- Medical University Vienna, Center for Physiology and Pharmacology, Institute of Pharmacology, Waehringerstrasse 13a, 1090 Vienna, Austria
| | - Constanze Nagy
- checkit!-Suchthilfe Wien gGmbH, Gumpendorferstraße8, 1060 Vienna, Austria
| | - Marion Holy
- Medical University Vienna, Center for Physiology and Pharmacology, Institute of Pharmacology, Waehringerstrasse 13a, 1090 Vienna, Austria
| | - Michael Freissmuth
- Medical University Vienna, Center for Physiology and Pharmacology, Institute of Pharmacology, Waehringerstrasse 13a, 1090 Vienna, Austria
| | - Rainer Schmid
- Medical University of Vienna, Clinical Department of Laboratory Medicine, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Harald H Sitte
- Medical University Vienna, Center for Physiology and Pharmacology, Institute of Pharmacology, Waehringerstrasse 13a, 1090 Vienna, Austria; Center for Addiction Research and Science - Medical University Vienna, Waehringerstrasse 13A, 1090 Vienna, Austria.
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24
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van Wijk XMR, Vittinghoff E, Wu AHB, Lynch KL, Riley ED. Cocaine use is associated with a higher prevalence of elevated ST2 concentrations. Clin Biochem 2017; 50:791-793. [PMID: 28442257 DOI: 10.1016/j.clinbiochem.2017.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 04/17/2017] [Accepted: 04/18/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Cocaine is a well-known risk factor for acute cardiac events, but the effects in users outside of acute events are less clear. We investigated a possible association between cocaine use and the concentration of a novel biomarker for cardiac stress and heart failure, ST2. METHODS A case-control study was conducted to compare ST2 concentrations by the presence of cocaine in patients presenting for care, but not cardiac care, at an urban safety net hospital. RESULTS In samples taken from 100 cocaine-positive and 100 cocaine-negative patients, the presence of cocaine was associated with ST2 concentrations>35ng/mL. Serum concentrations of benzoylecgonine, a major cocaine metabolite, were significantly correlated with ST2 concentrations. CONCLUSIONS Cocaine use is associated with subclinical cardiac stress and damage outside of acute cardiac events. This information could add to better stratification of cocaine users with elevated ST2 concentrations who may be at higher risk for developing heart failure and other cardiac complications.
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Affiliation(s)
- Xander M R van Wijk
- Department of Laboratory Medicine, Zuckerberg San Francisco General, University of California, San Francisco, CA, USA.
| | - Eric Vittinghoff
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Alan H B Wu
- Department of Laboratory Medicine, Zuckerberg San Francisco General, University of California, San Francisco, CA, USA
| | - Kara L Lynch
- Department of Laboratory Medicine, Zuckerberg San Francisco General, University of California, San Francisco, CA, USA
| | - Elise D Riley
- Division of HIV, Infectious Diseases and Global Health, Department of Medicine, University of California, San Francisco, CA, USA
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25
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Donroe JH, Tetrault JM. Substance Use, Intoxication, and Withdrawal in the Critical Care Setting. Crit Care Clin 2017; 33:543-558. [PMID: 28601134 DOI: 10.1016/j.ccc.2017.03.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Substance use is common among individuals admitted to the critical care setting and may complicate treatment of underlying disorders. Management issues include the effects of intoxication as well as the risk posed by substance-withdrawal syndromes in patients being treated for critical illness. This article reviews the epidemiology of substance use in this population and the identification and treatment of common intoxication and withdrawal syndromes. The authors stress the importance of long-term planning as part of the overall treatment protocol beyond the acute presentation.
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Affiliation(s)
- Joseph H Donroe
- Department of Internal Medicine, Yale University School of Medicine, St. Raphael Campus, Office M330, 1450 Chapel Street, New Haven, CT 06511, USA.
| | - Jeanette M Tetrault
- Department of Internal Medicine, Yale University School of Medicine, 367 Cedar Street, Suite 305, New Haven, CT 06510, USA
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26
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Anzanello MJ, Yamashita G, Marcelo M, Fogliatto FS, Ortiz RS, Mariotti K, Ferrão MF. A genetic algorithm-based framework for wavelength selection on sample categorization. Drug Test Anal 2017; 9:1172-1181. [DOI: 10.1002/dta.2138] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 10/15/2016] [Accepted: 11/15/2016] [Indexed: 11/07/2022]
Affiliation(s)
- Michel J. Anzanello
- Department of Industrial Engineering; Universidade Federal do Rio Grande do Sul; Porto Alegre RS Brazil
| | - Gabrielli Yamashita
- Department of Industrial Engineering; Universidade Federal do Rio Grande do Sul; Porto Alegre RS Brazil
| | - Marcelo Marcelo
- Chemistry Institut; Universidade Federal do Rio Grande do Sul; Porto Alegre Rio Grande do Sul Brazil
| | - Flávio S. Fogliatto
- Department of Industrial Engineering; Universidade Federal do Rio Grande do Sul; Porto Alegre RS Brazil
| | - Rafael S. Ortiz
- Rio Grande do Sul Technical and Scientifical Division; Brazilian Federal Police; Porto Alegre RS Brazil
| | - Kristiane Mariotti
- Department of Pharmacy; Universidade Federal do Rio Grande do Sul; Porto Alegre Rio Grande do Sul Brazil
| | - Marco F. Ferrão
- Chemistry Institut; Universidade Federal do Rio Grande do Sul; Porto Alegre Rio Grande do Sul Brazil
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27
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Ryu Y, Barceló D, Barron LP, Bijlsma L, Castiglioni S, de Voogt P, Emke E, Hernández F, Lai FY, Lopes A, de Alda ML, Mastroianni N, Munro K, O'Brien J, Ort C, Plósz BG, Reid MJ, Yargeau V, Thomas KV. Comparative measurement and quantitative risk assessment of alcohol consumption through wastewater-based epidemiology: An international study in 20 cities. THE SCIENCE OF THE TOTAL ENVIRONMENT 2016; 565:977-983. [PMID: 27188267 DOI: 10.1016/j.scitotenv.2016.04.138] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 04/13/2016] [Accepted: 04/19/2016] [Indexed: 05/22/2023]
Abstract
Quantitative measurement of drug consumption biomarkers in wastewater can provide objective information on community drug use patterns and trends. This study presents the measurement of alcohol consumption in 20 cities across 11 countries through the use of wastewater-based epidemiology (WBE), and reports the application of these data for the risk assessment of alcohol on a population scale using the margin of exposure (MOE) approach. Raw 24-h composite wastewater samples were collected over a one-week period from 20 cities following a common protocol. For each sample a specific and stable alcohol consumption biomarker, ethyl sulfate (EtS) was determined by liquid chromatography coupled to tandem mass spectrometry. The EtS concentrations were used for estimation of per capita alcohol consumption in each city, which was further compared with international reports and applied for risk assessment by MOE. The average per capita consumption in 20 cities ranged between 6.4 and 44.3L/day/1000 inhabitants. An increase in alcohol consumption during the weekend occurred in all cities, however the level of this increase was found to differ. In contrast to conventional data (sales statistics and interviews), WBE revealed geographical differences in the level and pattern of actual alcohol consumption at an inter-city level. All the sampled cities were in the "high risk" category (MOE<10) and the average MOE for the whole population studied was 2.5. These results allowed direct comparisons of alcohol consumption levels, patterns and risks among the cities. This study shows that WBE can provide timely and complementary information on alcohol use and alcohol associated risks in terms of exposure at the community level.
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Affiliation(s)
- Yeonsuk Ryu
- Norwegian Institute for Water Research (NIVA), Gaustadalleen 21, 0349 Oslo, Norway; Faculty of Medicine, University of Oslo, PO box 1078 Blindern, 0316 Oslo, Norway.
| | - Damià Barceló
- Water and Soil Quality Research Group, Department of Environmental Chemistry, Institute of Environmental Assessment and Water Research (IDAEA-CSIC), C/ Jordi Girona, 18-26, 08034 Barcelona, Spain; Catalan Institute for Water Research (ICRA), Parc Científic i Tecnològic de la Universitat de Girona, Edifici H2O, Emili Grahit 101, 17003 Girona, Spain
| | - Leon P Barron
- Analytical & Environmental Sciences Division, King's College London, 150 Stamford Street, SE1 9NH, London, United Kingdom
| | - Lubertus Bijlsma
- Research Institute for Pesticides and Water, University Jaume I, Avda. Sos Baynat, E-12071 Castellón, Spain
| | - Sara Castiglioni
- IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri", Department of Environmental Health Sciences, Via La Masa 19, 20156 Milan, Italy
| | - Pim de Voogt
- KWR Watercycle Research Institute, Chemical Water Quality and Health, P.O. Boxs 1072, 3430 BB Nieuwegein, The Netherlands; Institute for Biodiversity and Ecosystem Dynamics (IBED), University of Amsterdam, Science Park 904, 1098 XH Amsterdam, The Netherlands
| | - Erik Emke
- KWR Watercycle Research Institute, Chemical Water Quality and Health, P.O. Boxs 1072, 3430 BB Nieuwegein, The Netherlands
| | - Félix Hernández
- Research Institute for Pesticides and Water, University Jaume I, Avda. Sos Baynat, E-12071 Castellón, Spain
| | - Foon Yin Lai
- National Research Centre for Environmental Toxicology, The University of Queensland, Brisbane, QLD 4108, Australia
| | - Alvaro Lopes
- Faculty of Pharmacy, University of Lisbon, Av. Prof. Gama Pinto, 1649-003 Lisbon, Portugal
| | - Miren López de Alda
- Water and Soil Quality Research Group, Department of Environmental Chemistry, Institute of Environmental Assessment and Water Research (IDAEA-CSIC), C/ Jordi Girona, 18-26, 08034 Barcelona, Spain
| | - Nicola Mastroianni
- Water and Soil Quality Research Group, Department of Environmental Chemistry, Institute of Environmental Assessment and Water Research (IDAEA-CSIC), C/ Jordi Girona, 18-26, 08034 Barcelona, Spain
| | - Kelly Munro
- Analytical & Environmental Sciences Division, King's College London, 150 Stamford Street, SE1 9NH, London, United Kingdom
| | - Jake O'Brien
- National Research Centre for Environmental Toxicology, The University of Queensland, Brisbane, QLD 4108, Australia
| | - Christoph Ort
- Eawag, Swiss Federal Institute of Aquatic Science and Technology, CH, 8600 Dübendorf, Switzerland
| | - Benedek G Plósz
- Department of Environmental Engineering, Technical University of Denmark, Miljøvej, Building 113, 2800 Kgs, Lyngby, Denmark
| | - Malcolm J Reid
- Norwegian Institute for Water Research (NIVA), Gaustadalleen 21, 0349 Oslo, Norway
| | - Viviane Yargeau
- Department of Chemical Engineering, McGill University, 3610 University St., Montreal, QC J3N 1V3, Canada
| | - Kevin V Thomas
- Norwegian Institute for Water Research (NIVA), Gaustadalleen 21, 0349 Oslo, Norway
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Silveira GDO, Belitsky ÍT, Loddi S, Rodrigues de Oliveira CD, Zucoloto AD, Fruchtengarten LVG, Yonamine M. Development of a method for the determination of cocaine, cocaethylene and norcocaine in human breast milk using liquid phase microextraction and gas chromatography-mass spectrometry. Forensic Sci Int 2016; 265:22-8. [DOI: 10.1016/j.forsciint.2016.01.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 01/07/2016] [Accepted: 01/08/2016] [Indexed: 10/22/2022]
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Grasing K, Mathur D, DeSouza C, Newton TF, Moody DE, Sturgill M. Cocaine cardiovascular effects and pharmacokinetics after treatment with the acetylcholinesterase inhibitor donepezil. Am J Addict 2016; 25:392-9. [PMID: 27392137 DOI: 10.1111/ajad.12402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 06/11/2016] [Accepted: 06/25/2016] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND In rodents, cholinesterase inhibitors can cause sustained decreases in the reinforcing effects of cocaine. Nonetheless, cocaine is metabolized by butyrylcholinesterase (BuChE), raising concerns that cholinesterase inhibition could increase its peripheral concentrations, perhaps augmenting toxicity. Although donepezil is approved for use in patients and selective for inhibiting acetylcholinesterase over BuChE, no studies have reported cocaine bioavailability in human subjects receiving donepezil. METHODS Twelve cocaine-dependent veterans received three days of treatment with either oral placebo or 5 mg daily of donepezil, followed by cross-over to the opposite treatment. During both oral treatments, double-blind intravenous cocaine was administered at .0, .18, and .36 mg/kg in a laboratory setting, followed by determinations of heart rate, blood pressure, and plasma concentrations of cocaine and major metabolites. RESULTS Intravenous cocaine produced dose-related increases in systolic blood pressure that were most pronounced over the initial 30 minutes after treatment. Oral donepezil attenuated drug-induced elevations of systolic blood pressure following low-dose cocaine (.18 mg/kg). No significant difference in blood pressure following treatment with placebo or donepezil after high-dose cocaine (.36 mg/kg). Peak values of blood pressure and heart rate were unaffected by donepezil. Plasma concentrations of cocaine and metabolites did not differ in donepezil- and placebo-treated participants. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE We conclude that donepezil can attenuate drug-induced increases in systolic blood pressure following low-dose cocaine, but does not otherwise modify the cardiovascular effects of intravenous cocaine. Clinically significant changes in cocaine bioavailability and cardiovascular effects do not occur following this dose of donepezil. (Am J Addict 2016;25:392-399).
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Affiliation(s)
- Kenneth Grasing
- Substance Abuse Research Laboratory, Kansas City Veterans Affairs Medical Center, Kansas City, Missouri.,Division of Clinical Pharmacology, Department of Medicine, University of Kansas School of Medicine, Kansas City, Kansas
| | - Deepan Mathur
- Substance Abuse Research Laboratory, Kansas City Veterans Affairs Medical Center, Kansas City, Missouri
| | - Cherilyn DeSouza
- Substance Abuse Research Laboratory, Kansas City Veterans Affairs Medical Center, Kansas City, Missouri.,Department of Psychiatry, University of Kansas School of Medicine, Kansas City, Kansas
| | - Thomas F Newton
- Department of Psychiatry and Behavioral Science and The Michael E. DeBakey Department of Veterans Affairs Medical Center, Baylor College of Medicine, Houston, Texas
| | - David E Moody
- Department of Pharmacology and Toxicology, Center for Human Toxicology, University of Utah, Salt Lake City, Utah
| | - Marc Sturgill
- Department of Pharmacy Practice and Administration, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, New Jersey
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Coca: The History and Medical Significance of an Ancient Andean Tradition. Emerg Med Int 2016; 2016:4048764. [PMID: 27144028 PMCID: PMC4838786 DOI: 10.1155/2016/4048764] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 03/24/2016] [Indexed: 12/02/2022] Open
Abstract
Coca leaf products are an integral part of the lives of the Andean peoples from both a cultural and traditional medicine perspective. Coca is also the whole plant from which cocaine is derived. Coca products are thought to be a panacea for health troubles in regions of South America. This review will examine the toxicology of whole coca and will also look at medicinal applications of this plant, past, present, and future.
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M1 and M3 muscarinic receptors may play a role in the neurotoxicity of anhydroecgonine methyl ester, a cocaine pyrolysis product. Sci Rep 2015; 5:17555. [PMID: 26626425 PMCID: PMC4667193 DOI: 10.1038/srep17555] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 11/02/2015] [Indexed: 01/12/2023] Open
Abstract
The smoke of crack cocaine contains cocaine and its pyrolysis product, anhydroecgonine methyl ester (AEME). AEME possesses greater neurotoxic potential than cocaine and an additive effect when they are combined. Since atropine prevented AEME-induced neurotoxicity, it has been suggested that its toxic effects may involve the muscarinic cholinergic receptors (mAChRs). Our aim is to understand the interaction between AEME and mAChRs and how it can lead to neuronal death. Using a rat primary hippocampal cell culture, AEME was shown to cause a concentration-dependent increase on both total [3H]inositol phosphate and intracellular calcium, and to induce DNA fragmentation after 24 hours of exposure, in line with the activation of caspase-3 previously shown. Additionally, we assessed AEME activity at rat mAChR subtypes 1–5 heterologously expressed in Chinese Hamster Ovary cells. l-[N-methyl-3H]scopolamine competition binding showed a preference of AEME for the M2 subtype; calcium mobilization tests revealed partial agonist effects at M1 and M3 and antagonist activity at the remaining subtypes. The selective M1 and M3 antagonists and the phospholipase C inhibitor, were able to prevent AEME-induced neurotoxicity, suggesting that the toxicity is due to the partial agonist effect at M1 and M3 mAChRs, leading to DNA fragmentation and neuronal death by apoptosis.
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Anzanello M, Kahmann A, Marcelo M, Mariotti K, Ferrão M, Ortiz R. Multicriteria wavenumber selection in cocaine classification. J Pharm Biomed Anal 2015; 115:562-9. [DOI: 10.1016/j.jpba.2015.08.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 08/06/2015] [Accepted: 08/07/2015] [Indexed: 11/27/2022]
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Espana Schmidt C, Pastori L, Pekler G, Visco F, Mushiyev S. Early use of beta blockers in patients with cocaine associated chest pain. IJC HEART & VASCULATURE 2015; 8:167-169. [PMID: 28785697 PMCID: PMC5497278 DOI: 10.1016/j.ijcha.2015.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 06/12/2015] [Indexed: 10/26/2022]
Abstract
BACKGROUND The most common symptom of cocaine abuse is chest pain. Cocaine induced chest pain (CICP) shares patho-physiological pathways with the acute coronary syndromes (ACS). A key event is the increase of activity of the adrenergic system. Beta blockers (BBs), a cornerstone in the treatment of ACS, are felt to be contraindicated in the patient with CICP due to a potential of an "unopposed alpha adrenergic effect (UAE)". OBJECTIVES Identify signs of UAE and in-hospital complications in patients who received BB while having cocaine induced chest pain. METHODS We performed a retrospective review of 378 patients admitted to a medical unit because of CICP. Twenty six of these were given a BB at the time of admission while having CICP. We compared these patients to a control group paired by age, sex, race and history of hypertension who did not received a BB while having CICP. Blood pressure, heart rate, length of stay and in-hospital cardiovascular complications were compared. RESULTS No statistically significant differences were found between the two groups except for a longer length of stay in the case group. This was felt to be due to unrelated causes. CONCLUSIONS This study does not support the presence of an UAE in patients with continuing CICP and treated early with BB. There were no in-hospital cardiovascular complications in the group of patients who had an early dose of BB while having CICP. IMPLICATIONS BB appeared safe when given early on admission to patients with CICP.
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Affiliation(s)
- Christian Espana Schmidt
- Department of Medicine, Metropolitan Hospital Center/New York Medical College, New York, NY, United States
| | - Luciano Pastori
- Department of Medicine, Metropolitan Hospital Center/New York Medical College, New York, NY, United States
| | - Gerald Pekler
- Unit of Cardiology, Department of Medicine, Metropolitan Hospital Center/New York Medical College, New York, NY, United States
| | - Ferdinand Visco
- Unit of Cardiology, Department of Medicine, Metropolitan Hospital Center/New York Medical College, New York, NY, United States
| | - Savi Mushiyev
- Unit of Cardiology, Department of Medicine, Metropolitan Hospital Center/New York Medical College, New York, NY, United States
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34
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Stankowski RV, Kloner RA, Rezkalla SH. Cardiovascular consequences of cocaine use. Trends Cardiovasc Med 2015; 25:517-26. [DOI: 10.1016/j.tcm.2014.12.013] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 12/03/2014] [Accepted: 12/17/2014] [Indexed: 11/28/2022]
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Guollo F, Narciso-Schiavon JL, Barotto AM, Zannin M, Schiavon LL. Significance of alanine aminotransferase levels in patients admitted for cocaine intoxication. J Clin Gastroenterol 2015; 49:250-5. [PMID: 24518798 DOI: 10.1097/mcg.0000000000000056] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
BACKGROUND Experimental studies in animal models and case reports in humans have described the hepatotoxic potential of cocaine. However, there are few data regarding the clinical and laboratory characteristics of patients admitted for cocaine intoxication, particularly regarding the status of the liver enzymes. GOAL To investigate the significance of alanine aminotransferase (ALT) levels in individuals hospitalized for acute cocaine intoxication. METHODS Retrospective study with standardized chart review that included patients admitted between January 2003 and December 2010. Bivariate analyses were used to investigate factors associated with ALT above the upper tertile according to gender. Cases of marked ALT elevation were described in detail. RESULTS Ninety-three patients were included (79% men, mean age of 27.73±9.97 y). ALT above the upper tertile was associated with higher aspartate aminotransferase (AST), creatine phosphokinase, creatinine, and international normalized ratio. Higher levels of ALT were also related to acute renal failure and death. Five subjects had severe ALT elevation during follow-up and all had evidence of hepatocellular dysfunction (jaundice, prolonged prothrombin time with or without hepatic encephalopathy), rhabdomyolysis, and acute renal failure. AST/ALT ratio <2 was present in 2 subjects with severe ALT elevation at admission, but AST/ALT ratio >2 was observed in 3 cases with evidence of progression to acute liver injury. CONCLUSIONS In acute cocaine intoxication, higher ALT levels were associated with evidence of muscle damage, progression to acute renal failure, and death. Severe liver damage was observed in 5% of the sample and was associated with rhabdomyolysis and renal failure in all cases.
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Affiliation(s)
- Fernanda Guollo
- *Division of Gastroenterology, Federal University of Santa Catarina, Florianópolis †Center for Toxicological Information of Santa Catarina (CIT/SC), SC, Brazil
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Marcelo M, Mariotti K, Ferrão M, Ortiz R. Profiling cocaine by ATR–FTIR. Forensic Sci Int 2015; 246:65-71. [DOI: 10.1016/j.forsciint.2014.11.011] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2014] [Revised: 10/31/2014] [Accepted: 11/13/2014] [Indexed: 10/24/2022]
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Lopes A, Silva N, Bronze MR, Ferreira J, Morais J. Analysis of cocaine and nicotine metabolites in wastewater by liquid chromatography-tandem mass spectrometry. Cross abuse index patterns on a major community. THE SCIENCE OF THE TOTAL ENVIRONMENT 2014; 487:673-80. [PMID: 24200094 DOI: 10.1016/j.scitotenv.2013.10.042] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2013] [Revised: 10/11/2013] [Accepted: 10/11/2013] [Indexed: 05/15/2023]
Abstract
A method based on sample preparation by solid phase extraction and analysis by liquid chromatography and mass spectrometry was validated and used for simultaneous analysis of cocaine, benzoylecgonine and cotinine in samples collected at the major wastewater treatment plant in the city of Lisbon. The aim was to estimate the consumption of both cocaine and nicotine in this community and establish an index involving both drugs supported by the relevance of nicotine as a significant anthropogenic marker. The study was made on two different weekdays during a month in order to evaluate patterns of consumption outside weekends. Cocaine and nicotine ingestion levels were back-calculated and expressed as mass of pure drugs consumed per day and per 1000 inhabitants (mean: 0.604 g and 5.860 g respectively). Cocaine was also expressed on the basis of local drug purity levels (33.7%) with a corresponding increase on dose assessments, and community drug abuse profiles. The authors sustain that this approach should always be included in drug studies of this kind allowing a better drug abuse assessment. No significant different patterns of consumption were obtained during the working days studied with the exception of one case coincident with a national holiday that showed an increased typical profile found on other non-working day studies, namely weekends. A fairly significant relationship was found between nicotine and cocaine consumption that should be further evaluated in future studies. Pharmacokinetic considerations were made and proposed for cocaine assessment based on the impact on back calculations after common simultaneous consumption of cocaine and ethanol.
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Affiliation(s)
- Alvaro Lopes
- Faculty of Pharmacy, University of Lisbon, Av. Prof. Gama Pinto, 1649-003 Lisbon, Portugal; Instituto Superior de Ciências da Saúde Egas Moniz, Quinta da Granja, Monte de Caparica, 2829-511 Caparica, Portugal.
| | - Nuno Silva
- iMed - Research Institute for Medicines and Pharmaceutical Sciences, Faculty of Pharmacy, University of Lisbon, Av. Prof. Gama Pinto, 1649-003 Lisbon, Portugal
| | - M R Bronze
- iMed - Research Institute for Medicines and Pharmaceutical Sciences, Faculty of Pharmacy, University of Lisbon, Av. Prof. Gama Pinto, 1649-003 Lisbon, Portugal; IBET, Instituto de Biologia Experimental e Tecnológica, Apartado 12, 2781-901 Oeiras, Portugal; ITQB, Instituto de Tecnologia Química e Biológica, Universidade Nova de Lisboa, Avenida da República, Estação Agronómica Nacional, 2780-157 Oeiras, Portugal
| | - João Ferreira
- iMed - Research Institute for Medicines and Pharmaceutical Sciences, Faculty of Pharmacy, University of Lisbon, Av. Prof. Gama Pinto, 1649-003 Lisbon, Portugal
| | - José Morais
- iMed - Research Institute for Medicines and Pharmaceutical Sciences, Faculty of Pharmacy, University of Lisbon, Av. Prof. Gama Pinto, 1649-003 Lisbon, Portugal
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Alvear E, von Baer D, Mardones C, Hitschfeld A. Determination of cocaine and its major metabolite benzoylecgonine in several matrices obtained from deceased individuals with presumed drug consumption prior to death. J Forensic Leg Med 2014; 23:37-43. [PMID: 24661704 DOI: 10.1016/j.jflm.2014.01.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Revised: 11/05/2013] [Accepted: 01/19/2014] [Indexed: 12/12/2022]
Abstract
In the field of forensic toxicology, femoral blood is the most useful sample for the determination and quantification of drugs; however, cases in which blood is unavailable are common. In such cases, validated methodologies for drug determination in alternative matrices can be decisive in the investigation of a case. In particular, when femoral blood is unavailable for analysis for the presence of systemic exposure to cocaine and its principal metabolite, benzoylecgonine, validated methodologies from matrices other than blood that can be obtained in the autopsy room would be useful to the forensic toxicologist in the evaluation of a specific forensic case. To address this issue, we implemented and compared in our study the systematic evaluation of extraction, chromatographic separation, and quantification of cocaine and benzoylecgonine in different biological matrices (right and left cardiac blood, femoral arterial and venous blood, urine, vitreous humor, cerebrospinal fluid, brain accumbens nucleus, brain ventral tegmental area, and liver). The studied matrices were those most likely to be obtained from different autopsy rooms at the time of forensic testing in deceased individuals who are presumed of antemortem drug consumption. Solid phase extraction of analytes from the different matrices was performed using C-8/SCX mixed-phase columns, and gas chromatographic mass spectrometry separation was performed using detection in single-ion monitoring mode. The methodological validation was performed for all the studied matrices, and the results showed similar sensitivity and recoveries without statistical differences between the studied matrices. The methods were applied to evaluate a thanatological case using all the study matrices, showing unequal postmortem distribution of cocaine and benzoylecgonine throughout the different matrices tested. The present work opens the option of applying appropriate methodologies in the analysis of matrices, other than the usual blood, to obtain reliable results that may help clarify a forensic case. In addition, we present findings from different studies. This work affirms not only the potentiality of obtaining reliable data but also reaffirms the challenge of applying these data and taking into account the complexity of interpreting results in matrices other than blood.
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Affiliation(s)
- Eduardo Alvear
- Servicio Médico Legal de Concepción, Laboratorio, Camino a Penco 4018, Concepción, Chile
| | - Dietrich von Baer
- Universidad de Concepción, Facultad de Farmacia - Depto de Análisis Instrumental, Barrio Universitario s/n, Concepción, Chile.
| | - Claudia Mardones
- Universidad de Concepción, Facultad de Farmacia - Depto de Análisis Instrumental, Barrio Universitario s/n, Concepción, Chile
| | - Antonieta Hitschfeld
- Universidad de Concepción, Facultad de Farmacia - Depto de Análisis Instrumental, Barrio Universitario s/n, Concepción, Chile
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Abstract
Rhabdomyolysis is a well-known clinical syndrome of muscle injury associated with myoglobinuria, electrolyte abnormalities, and often acute kidney injury (AKI). The pathophysiology involves injury to the myocyte membrane and/or altered energy production that results in increased intracellular calcium concentrations and initiation of destructive processes. Myoglobin has been identified as the primary muscle constituent contributing to renal damage in rhabdomyolysis. Although rhabdomyolysis was first described with crush injuries and trauma, more common causes in hospitalized patients at present include prescription and over-the-counter medications, alcohol, and illicit drugs. The diagnosis is confirmed by elevated creatine kinase levels, but additional testing is needed to evaluate for potential causes, electrolyte abnormalities, and AKI. Treatment is aimed at discontinuation of further skeletal muscle damage, prevention of acute renal failure, and rapid identification of potentially life-threatening complications. Review of existing published data reveals a lack of high-quality evidence to support many interventions that are often recommended for treating rhabdomyolysis. Early and aggressive fluid resuscitation to restore renal perfusion and increase urine flow is agreed on as the main intervention for preventing and treating AKI. There is little evidence other than from animal studies, retrospective observational studies, and case series to support the routine use of bicarbonate-containing fluids, mannitol, and loop diuretics. Hyperkalemia and compartment syndrome are additional complications of rhabdomyolysis that must be treated effectively. A definite need exists for well-designed prospective studies to determine the optimal management of rhabdomyolysis.
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Affiliation(s)
- Janice L Zimmerman
- Methodist Hospital, Houston, TX; Weill Cornell Medical College New York, NY.
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Scantling D, Klonoski E, Valentino DJ. Use of therapeutic hypothermia in cocaine-induced cardiac arrest: further evidence. Am J Crit Care 2014; 23:89-92. [PMID: 24382622 DOI: 10.4037/ajcc2014299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Therapeutic hypothermia is an important and successful treatment that has been endorsed only in specific clinical settings of cardiac arrest. Inclusion criteria thus far have not embraced drug-induced cardiac arrest, but clinical evidence has been mounting that therapeutic hypothermia may be beneficial in such cases. A 59-year-old man who experienced a cocaine-induced cardiac arrest had a full neurological recovery after use of therapeutic hypothermia. The relevant pathophysiology of cocaine-induced cardiac arrest is reviewed, the mechanism and history of therapeutic hypothermia are discussed, and the clinical evidence recommending the use of therapeutic hypothermia in cocaine-induced cardiac arrest is reinforced.
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Affiliation(s)
- Dane Scantling
- Dane Scantling is a fourth year medical student at The Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania. Emily Klonoski is an internal medicine resident a St Luke’s University Health Network in Bethlehem, Pennsylvania. Dominic J. Valentino III is the medical director of critical care at Mercy Fitzgerald Hospital in Darby, Pennsylvania
| | - Emily Klonoski
- Dane Scantling is a fourth year medical student at The Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania. Emily Klonoski is an internal medicine resident a St Luke’s University Health Network in Bethlehem, Pennsylvania. Dominic J. Valentino III is the medical director of critical care at Mercy Fitzgerald Hospital in Darby, Pennsylvania
| | - Dominic J. Valentino
- Dane Scantling is a fourth year medical student at The Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania. Emily Klonoski is an internal medicine resident a St Luke’s University Health Network in Bethlehem, Pennsylvania. Dominic J. Valentino III is the medical director of critical care at Mercy Fitzgerald Hospital in Darby, Pennsylvania
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Wielenga V, Gilchrist D. From gold-medal glory to prohibition: the early evolution of cocaine in the United Kingdom and the United States. JRSM SHORT REPORTS 2013; 4:2042533313478324. [PMID: 23772315 PMCID: PMC3681233 DOI: 10.1177/2042533313478324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
As reported in the 2011 World Drug Report, cocaine is likely to be the most problematic drug worldwide in terms of trafficking-related violence and second only to heroin in terms of negative health consequences and drug deaths. Over a period of 60 years, cocaine evolved from the celebrated panacea of the 1860s to outlawed street drug of the 1920s. As demonstrated by the evolution of cocaine use and abuse in the United Kingdom and United States during this time period, cultural attitudes influenced both the acceptance of cocaine into the medical field and the reaction to the harmful effects of cocaine. Our review of articles on cocaine use in the United Kingdom and the United States from 1860 to 1920 reveals an attitude of caution in the United Kingdom compared with an attitude of progressivism in the United States. When the trends in medical literature are viewed in the context of the development of drug regulations, our analysis provides insight into the relationship between cultural attitudes and drug policy, supporting the premise that it is cultural and social factors which shape drug policy, rather than drug regulations changing culture.
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Affiliation(s)
- Vicki Wielenga
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta T6G 2H7, Canada
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Pedriali A, Riva C, Parolini M, Cristoni S, Sheehan D, Binelli A. A redox proteomic investigation of oxidative stress caused by benzoylecgonine in the freshwater bivalveDreissena polymorpha. Drug Test Anal 2012; 5:646-56. [DOI: 10.1002/dta.1409] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Revised: 08/04/2012] [Accepted: 08/13/2012] [Indexed: 11/10/2022]
Affiliation(s)
- Alessandra Pedriali
- University of Milan; Department of Life Sciences; via Celoria 26; 20133; Milan; Italy
| | - Consuelo Riva
- University of Milan; Department of Life Sciences; via Celoria 26; 20133; Milan; Italy
| | - Marco Parolini
- University of Milan; Department of Life Sciences; via Celoria 26; 20133; Milan; Italy
| | - Simone Cristoni
- ISB Ion Source & Biotechnologies S.r.l.; via Lepetit 34; 21040; Gerenzano (VA); Italy
| | - David Sheehan
- Proteomics Research Group; Department of Biochemistry and Environmental Research Institute University College Cork; Lee Maltings, Prospect Row, Mardyke; Cork; Ireland
| | - Andrea Binelli
- University of Milan; Department of Life Sciences; via Celoria 26; 20133; Milan; Italy
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Abstract
Cocaine, a natural alkaloid derived from the coca plant, is one of the most commonly abused illicit drugs. Cocaine is commonly abused by inhalation, nasal insufflation, and intravenous injection, resulting in many adverse effects that ensue from local anesthetic, vasoconstrictive, sympathomimetic, psychoactive, and prothrombotic mechanisms. Cocaine can affect all body systems and the clinical presentation may primarily result from organ toxicity. Among the most severe complications are seizures, hemorrhagic and ischemic strokes, myocardial infarction, aortic dissection, rhabdomyolysis, mesenteric ischemia, acute renal injury and multiple organ failure.
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Affiliation(s)
- Janice L Zimmerman
- Department of Medicine, Weill Cornell Medical College, New York, NY, USA.
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Fox HC, Seo D, Tuit K, Hansen J, Kimmerling A, Morgan PT, Sinha R. Guanfacine effects on stress, drug craving and prefrontal activation in cocaine dependent individuals: preliminary findings. J Psychopharmacol 2012; 26:958-72. [PMID: 22234929 PMCID: PMC3694403 DOI: 10.1177/0269881111430746] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Cocaine dependence is associated with increased stress and drug cue-induced craving and physiological arousal but decreased prefrontal activity to emotional and cognitive challenge. As these changes are associated with relapse risk, we investigated the effects of α2 receptor agonist guanfacine on these processes. Twenty-nine early abstinent treatment-seeking cocaine dependent individuals were randomly assigned to either daily placebo or guanfacine (up to 3 mg) for four weeks. In a laboratory experiment, all patients were exposed to three 10-min guided imagery conditions (stress/stress, drug cue/drug cue, stress/drug cue), one per day, consecutively in a random, counterbalanced order. Subjective craving, anxiety and arousal as well as cardiovascular output were assessed repeatedly. Brain response to stress, drug cue and relaxing imagery was also assessed during a functional magnetic resonance (fMRI) imaging session. In the current study, guanfacine was found to be safe and well-tolerated. Lower basal heart rate and blood pressure was observed in the guanfacine versus placebo group. Guanfacine lowered stress and cue-induced nicotine craving and cue-induced cocaine craving, anxiety and arousal. The guanfacine group also showed increased medial and lateral prefrontal activity following stress and drug cue exposure compared with placebo. Data suggest further exploration of guanfacine is warranted in terms of its potential for reducing stress-induced and cue-induced drug craving and arousal.
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Affiliation(s)
- Helen C. Fox
- The Connecticut Mental Health Center, Yale University School of Medicine, Department of Psychiatry, New Haven, CT, USA
| | - Dongju Seo
- The Yale Stress Center, Yale University School of Medicine, Department of Psychiatry, New Haven, CT, USA
| | - Keri Tuit
- The Connecticut Mental Health Center, Yale University School of Medicine, Department of Psychiatry, New Haven, CT, USA,The Yale Stress Center, Yale University School of Medicine, Department of Psychiatry, New Haven, CT, USA
| | - Julie Hansen
- The Yale Stress Center, Yale University School of Medicine, Department of Psychiatry, New Haven, CT, USA
| | - Anne Kimmerling
- The Connecticut Mental Health Center, Yale University School of Medicine, Department of Psychiatry, New Haven, CT, USA
| | - Peter T. Morgan
- The Connecticut Mental Health Center, Yale University School of Medicine, Department of Psychiatry, New Haven, CT, USA
| | - Rajita Sinha
- The Connecticut Mental Health Center, Yale University School of Medicine, Department of Psychiatry, New Haven, CT, USA,The Yale Stress Center, Yale University School of Medicine, Department of Psychiatry, New Haven, CT, USA,The Child Study Center, Yale University School of Medicine, New Haven, CT, USA
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45
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The effects of cannabinoid CB1, CB2 and vanilloid TRPV1 receptor antagonists on cocaine addictive behavior in rats. Brain Res 2012; 1444:45-54. [DOI: 10.1016/j.brainres.2012.01.030] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2011] [Revised: 12/19/2011] [Accepted: 01/12/2012] [Indexed: 12/11/2022]
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Binelli A, Pedriali A, Riva C, Parolini M. Illicit drugs as new environmental pollutants: cyto-genotoxic effects of cocaine on the biological model Dreissena polymorpha. CHEMOSPHERE 2012; 86:906-911. [PMID: 22119280 DOI: 10.1016/j.chemosphere.2011.10.056] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2011] [Revised: 10/21/2011] [Accepted: 10/30/2011] [Indexed: 05/31/2023]
Abstract
The increase in global consumption of illicit drugs has produced not only social and medical problems but also a potential new environmental danger. Indeed, it has been established that drugs consumed by humans end up in surface waters, after being carried through the sewage system. Although many studies to measure concentrations of several drugs of abuse in freshwater worldwide have been conducted, no data have been available to evaluate their potentially harmful effects on non-target organisms until now. The present study represents the first attempt to investigate the cyto-genotoxic effects of cocaine, one of the primary drugs consumed in Western Countries, in the biological model Dreissena polymorpha by the use of a biomarker battery. We performed the following tests on Zebra mussel hemocytes: the single cell gel electrophoresis (SCGE) assay, the apoptosis frequency evaluation and the micronucleus assay (MN test) for the evaluation of genotoxicity and the lysosomal membranes stability test (neutral red retention assay; NRRA) to identify the cocaine cytotoxicity. We exposed the molluscs for 96 h to three different nominal concentrations in water (40 ng L(-1); 220 ng L(-1); and 10 μg L(-1)). Cocaine caused significant (p<0.05) primary DNA damage in this short-term experiment, but it also caused a clear increase in micronucleated cells and a marked rise in apoptosis, which was evident in samples from even the lowest environmental cocaine concentration. Because cocaine decreased the stability of lysosomal membranes, we also highlighted its cytotoxicity and the possible implications of oxidative stress for the observed genotoxic effects.
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Affiliation(s)
- A Binelli
- Department of Biology, University of Milan, Via Celoria 26, 20133 Milan, Italy.
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47
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Adamczyk P, Faron-Górecka A, Kuśmider M, Dziedzicka-Wasylewska M, Papp M, Filip M. Long-lasting increase in [³H]CP55,940 binding to CB1 receptors following cocaine self-administration and its withdrawal in rats. Brain Res 2012; 1451:34-43. [PMID: 22425184 DOI: 10.1016/j.brainres.2012.02.052] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2012] [Revised: 02/09/2012] [Accepted: 02/19/2012] [Indexed: 02/03/2023]
Abstract
The present work has aimed on the neuroadaptive changes in CB1 receptor density that are evoked by self-administered cocaine use and subsequent withdrawal in rats. We employed a quantitative autoradiographic analysis using labeled [³H]CP55,940, a CB1 receptor agonist. To distinguish the passive pharmacological effects of cocaine from those related to motivation and the cognitive processes evoked by active cocaine self-administration, the "yoked" procedure was used. Our results demonstrate that repeated cocaine administration over 14 days induced up-regulation of CB1 receptors in the cortical and subcortical brain areas of animals who received cocaine, whether the cocaine was actively self-administered or received passively (the "yoked" control group) and that the neuroadaptation of CB1 receptors persisted after the 10-day extinction phase. On the other hand, we found that only self-administering rats showed CB1 receptor up-regulation in numerous brain areas, which suggests that these structures may be directly linked to CB1 receptor control over motivational and cognitive processes. Moreover, the observed increase in [³H]CP55,940 binding in these brain areas likely indicates long-lasting neurobiological adaptations resulting from chronic cocaine self-administration. In conclusion, we demonstrated that chronic cocaine self-administration leads to increased CB1 receptor levels in numerous brain areas and that this neuroadaptation is maintained over a long-lasting extinction period.
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Affiliation(s)
- Przemysław Adamczyk
- Laboratory of Drug Addiction Pharmacology, Department of Pharmacology, Institute of Pharmacology Polish Academy of Sciences, Krakow, Poland.
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48
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Ben Lakhdar C, Bastianic T. Economic constraint and modes of consumption of addictive goods. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2011; 22:360-5. [DOI: 10.1016/j.drugpo.2011.03.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2010] [Revised: 03/04/2011] [Accepted: 03/14/2011] [Indexed: 11/25/2022]
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Bioanalytical methods for the determination of cocaine and metabolites in human biological samples. Bioanalysis 2011; 1:977-1000. [PMID: 21083066 DOI: 10.4155/bio.09.72] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Determination of cocaine and its metabolites in biological specimens is of great importance, not only in clinical and forensic toxicology, but also in workplace drug testing. These compounds are normally screened for using sensitive immunological methods. However, screening methods are unspecific and, therefore, the posterior confirmation of presumably positive samples by a specific technique is mandatory. Although GC-MS-based techniques are still the most commonly used for confirmation purposes of cocaine and its metabolites in biological specimens, the advent of LC-MS and LC-MS/MS has enabled the detection of even lower amounts of these drugs, which assumes particular importance when sample volume available is small, as frequently occurs with oral fluid. This paper will review recently-published papers that describe procedures for detection of cocaine and metabolites, not only in the most commonly used specimens, such as blood and urine, but also in other 'alternative' matrices (e.g., oral fluid and hair) with a special focus on sample preparation and chromatographic analysis.
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50
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Confluent muscle pallor: a macroscopic marker of cocaine-induced rhabdomyolysis. Forensic Sci Med Pathol 2011; 7:364-6. [PMID: 21380787 DOI: 10.1007/s12024-011-9229-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2011] [Indexed: 10/18/2022]
Abstract
A 39-year-old man presenting with acute delirium is reported who suffered an unexpected cardiac arrest shortly after being sedated. Death followed 2 days later from hypoxic-ischemic encephalopathy. At autopsy, marked pallor and edema of his left sternomastoid muscle was observed which was shown on microscopy to be due to confluent coagulative necrosis. Myoglobin casts in his renal tubules corresponded to an antemortem creatine phosphokinase level of 31,940 U/l. Death was due to rhabdomyolyisis and excited delirium complicating cocaine toxicity with hypoxic-ischemic encephalopathy, against a background of atherosclerotic coronary artery disease. Extensive confluent pallor in a single muscle may be a useful marker of chronic cocaine exposure associated with hyperthermia and muscle necrosis. Confirmatory toxicology is required.
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