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Elliott SP, Holdbrook T, Brandt SD. Prodrugs of New Psychoactive Substances (NPS): A New Challenge. J Forensic Sci 2020; 65:913-920. [DOI: 10.1111/1556-4029.14268] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 11/29/2019] [Accepted: 12/17/2019] [Indexed: 12/20/2022]
Affiliation(s)
- Simon P. Elliott
- Elliott Forensic Consulting Birmingham U.K
- Department of Analytical, Environmental and Forensic Sciences King’s College London London U.K
| | - Tanith Holdbrook
- Department of Analytical, Environmental and Forensic Sciences King’s College London London U.K
| | - Simon D. Brandt
- School of Pharmacy and Biomolecular Sciences Liverpool John Moores University Liverpool U.K
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2
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Wenthur CJ, Zhou B, Janda KD. Vaccine-driven pharmacodynamic dissection and mitigation of fenethylline psychoactivity. Nature 2017; 548:476-479. [PMID: 28813419 PMCID: PMC5957549 DOI: 10.1038/nature23464] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 07/03/2017] [Indexed: 01/09/2023]
Abstract
Fenethylline, also known as Captagon, is a synthetic psychoactive
stimulant that has recently been linked to substance use disorder and
‘pharmacoterrorism’ in the Middle East.1–4 Although fenethylline shares a common phenethylamine core
with other amphetamine-type stimulants, it additionally incorporates a
covalently-linked xanthine moiety into its parent structure.5,6
These independently-active pharmacophores are liberated during metabolism,
resulting in a structurally-diverse chemical mixture being deployed to the
central nervous system.7–9 Although
fenethylline’s psychoactive properties have been reported to differ from
other synthetic stimulants, the in vivo chemical complexity it
manifests upon ingestion has impeded efforts to unambiguously identify the
specific species responsible for these effects.10,11 Here we develop a ‘dissection through
vaccination’ approach, called DISSECTIV, to mitigate
fenethylline’s psychoactivity and show that its rapid-onset and distinct
psychoactive properties are facilitated by functional synergy between
theophylline and amphetamine. Our results demonstrate that incremental
vaccination against single chemical species within a multi-component mixture can
be used to uncover emergent properties arising from polypharmacologic activity.
We anticipate that DISSECTIV will be employed to expose unidentified active
chemical species and illuminate pharmacodynamic interactions within other
chemically complex systems, such as those found in counterfeit or illegal drug
preparations, post-metabolic tissue samples, and natural product extracts.
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Affiliation(s)
- Cody J Wenthur
- Department of Chemistry, The Skaggs Institute for Chemical Biology, The Scripps Research Institute, La Jolla, California 92037, USA.,Department of Immunology, WIRM Institute for Research and Medicine, The Scripps Research Institute, La Jolla, California 92037, USA
| | - Bin Zhou
- Department of Chemistry, The Skaggs Institute for Chemical Biology, The Scripps Research Institute, La Jolla, California 92037, USA.,Department of Immunology, WIRM Institute for Research and Medicine, The Scripps Research Institute, La Jolla, California 92037, USA
| | - Kim D Janda
- Department of Chemistry, The Skaggs Institute for Chemical Biology, The Scripps Research Institute, La Jolla, California 92037, USA.,Department of Immunology, WIRM Institute for Research and Medicine, The Scripps Research Institute, La Jolla, California 92037, USA
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3
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Twark C, Suzuki J. Fenethylline-Induced Psychosis, Fenethylline-Themed Paranoid Delusions, or Both? PSYCHOSOMATICS 2017; 58:561-564. [PMID: 28577859 DOI: 10.1016/j.psym.2017.03.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 03/24/2017] [Accepted: 03/26/2017] [Indexed: 11/15/2022]
Affiliation(s)
- Claire Twark
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Longwood Psychiatry Residency Training Program, Building for Transformative Medicine, Boston, MA.
| | - Joji Suzuki
- Division of Addiction Psychiatry, Brigham and Women's Hospital, Building for Transformative Medicine, Boston, MA
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4
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Katselou M, Papoutsis I, Nikolaou P, Qammaz S, Spiliopoulou C, Athanaselis S. Fenethylline (Captagon) Abuse - Local Problems from an Old Drug Become Universal. Basic Clin Pharmacol Toxicol 2016; 119:133-40. [DOI: 10.1111/bcpt.12584] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 03/10/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Maria Katselou
- Department of Forensic Medicine and Toxicology; Faculty of Medicine; National and Kapodistrian University of Athens; Athens Greece
| | - Ioannis Papoutsis
- Department of Forensic Medicine and Toxicology; Faculty of Medicine; National and Kapodistrian University of Athens; Athens Greece
| | - Panagiota Nikolaou
- Department of Forensic Medicine and Toxicology; Faculty of Medicine; National and Kapodistrian University of Athens; Athens Greece
| | - Samir Qammaz
- Department of Forensic Medicine and Toxicology; Faculty of Medicine; National and Kapodistrian University of Athens; Athens Greece
| | - Chara Spiliopoulou
- Department of Forensic Medicine and Toxicology; Faculty of Medicine; National and Kapodistrian University of Athens; Athens Greece
| | - Sotiris Athanaselis
- Department of Forensic Medicine and Toxicology; Faculty of Medicine; National and Kapodistrian University of Athens; Athens Greece
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5
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Khan U, Nicell JA. Sewer epidemiology mass balances for assessing the illicit use of methamphetamine, amphetamine and tetrahydrocannabinol. THE SCIENCE OF THE TOTAL ENVIRONMENT 2012; 421-422:144-162. [PMID: 22361587 DOI: 10.1016/j.scitotenv.2012.01.020] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2011] [Revised: 01/05/2012] [Accepted: 01/05/2012] [Indexed: 05/31/2023]
Abstract
In sewer epidemiology, mass balances are used to back-extrapolate measurements of wastewater influent concentrations of appropriate drug residues to assess the parent illicit drug's level of use in upstream populations. This study focussed on developing and refining mass balances for the use of illicit methamphetamine, amphetamine and tetrahydrocannabinol. As a first step, a multi-criteria evaluation was used to select unchanged methamphetamine, unchanged amphetamine and 11-nor-9-carboxy-tetrahydrocannabinol as the most appropriate drug residues to track a selected population's use of illicit methamphetamine, amphetamine and tetrahydrocannabinol, respectively. For each of these selected drug residues, mass balances were developed by utilizing all disposition data available for their release from all their respective sources, incorporating route-of-administration considerations where relevant, and accounting for variations in the metabolic capacity of users of the various relevant licit and illicit sources. Further, since the selected drug residues for the use of methamphetamine and amphetamine cannot only result from their use but numerous other licit and illicit sources, comprehensive general source models were developed for their enantiomeric-specific release to sewers. The relative importance of the sources identified in the general source model was evaluated by performing national substance flow analyses for a number of countries. Results suggested that licit sources of methamphetamine are expected to be only of significance in populations where its illicit use is minor. Similarly, in populations where the use of illicitly produced amphetamine is currently of relevance, licit contributions to the sewer loads of amphetamine are likely to be of negligible importance. Lastly, the study of tetrahydrocannabinol back-extrapolation mass balances suggested that further research is required to assess the importance of fecal elimination of 11-nor-9-carboxy-tetrahydrocannabinol.
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Affiliation(s)
- Usman Khan
- Department of Civil Engineering & Applied Mechanics, McGill University, 817 Sherbrooke St. West, Montreal, Quebec, Canada H3A 2K6
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6
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Oelschläger H, Harsche C, Engel J. Synthese, Biotransformation und Pharmakodynamik eines neuen Theophyllinderivats. Arch Pharm (Weinheim) 2010. [DOI: 10.1002/ardp.2503240904] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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7
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de la Torre R, Farré M, Navarro M, Pacifici R, Zuccaro P, Pichini S. Clinical pharmacokinetics of amfetamine and related substances: monitoring in conventional and non-conventional matrices. Clin Pharmacokinet 2004; 43:157-85. [PMID: 14871155 DOI: 10.2165/00003088-200443030-00002] [Citation(s) in RCA: 108] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Consumption of amfetamine-type stimulants, including classical amfetamines and 'designer drugs', has been recognised as one of the most significant trends in drug abuse at the end of the past century and at the beginning of the current one. The first cause is the increasing consumption amongst youth of methylenedioxy- and methoxy-substituted amfetamines, of which the pharmacology in humans is currently under investigation. Secondly, the abuse of more classical amfetamines, such as amfetamine itself and metamfetamine, continues to be highly prevalent in some geographical regions. Amfetamines are powerful psychostimulants, producing increased alertness, wakefulness, insomnia, energy and self-confidence in association with decreased fatigue and appetite as well as enhanced mood, well-being and euphoria. From a clinical pharmacokinetic perspective, amfetamine-type stimulants are rather homogeneous. Their oral bioavailability is good, with a high distribution volume (4 L/kg) and low binding to plasma proteins (less than 20%). The elimination half-life is 6-12 hours. Both hepatic and renal clearance contribute to their elimination from the body. Hepatic metabolism is extensive in most cases, but a significant percentage of the drug always remains unaltered. Amfetamine and related compounds are weak bases, with a pKa around 9.9, and a relatively low molecular weight. These characteristics allow amfetamine-type stimulants to diffuse easily across cell membranes and lipid layers and to those tissues or biological substrates with a more acidic pH than blood, facilitating their detection in alternative matrices at relatively high concentrations. In most cases, the concentrations found are higher than expected from the Henderson-Hasselbach equation. Drug monitoring in non-conventional biological matrices (e.g. saliva, hair, nails, sweat) has recently gained much attention because of its possible applications in clinical and forensic toxicology. An individual's past history of medication, compliance or drug abuse can be obtained from testing of hair and nails, whereas data on current status of drug use can be provided by analysis of sweat and saliva. Because of the physicochemical properties of amfetamine-type stimulants, this group of drugs is one of the most suitable for drug testing in non-conventional matrices.
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Affiliation(s)
- Rafael de la Torre
- Pharmacology Unit, Institut Municipal d'Investigació Mèdica, Barcelona, Spain
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8
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Cody JT. Precursor medications as a source of methamphetamine and/or amphetamine positive drug testing results. J Occup Environ Med 2002; 44:435-50. [PMID: 12024689 DOI: 10.1097/00043764-200205000-00012] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Medical Review Officer interpretation of laboratory results is an important component of drug testing programs. The clinical evaluation of laboratory results to assess the possibility of appropriate medical use of a drug is a task with many different facets, depending on the drug class considered. This intercession prevents the reporting of positive results unless it is apparent that drugs were used illicitly. In addition to the commonly encountered prescribed drugs that yield positive drug testing results, other sources of positive results must be considered. This review describes a series of compounds referred to as "precursor" drugs that are metabolized by the body to amphetamine and/or methamphetamine. These compounds lead to positive results for amphetamines even though neither amphetamine nor methamphetamine were used, a possibility that must be considered in the review of laboratory results. Description of the drugs, their clinical indications, and results seen following administration are provided. This information allows for the informed evaluation of results with regard to the potential involvement of these drugs.
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Affiliation(s)
- John T Cody
- Academy of Health Sciences, MCCS-HMP PA Branch, 3151 Scott Road, Ft Sam, Houston, TX 78234-6138, USA.
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9
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Kikura R, Nakahara Y, Kojima S. Simultaneous determination of dimethylamphetamine and its metabolites in rat hair by gas chromatography-mass spectrometry. JOURNAL OF CHROMATOGRAPHY. B, BIOMEDICAL SCIENCES AND APPLICATIONS 2000; 741:163-73. [PMID: 10872586 DOI: 10.1016/s0378-4347(00)00046-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In order to study the disposition of dimethylamphetamine (DMAP) and its metabolites, DMAP N-oxide, methamphetamine (MA) and amphetamine (AP), from plasma to hair in rats, a simultaneous determination method for these compounds in biological samples using gas chromatography-mass spectrometry with selected ion monitoring (GC-MS-SIM) was developed. As DMAP N-oxide partially degrades to DMAP and MA during GC-MS analysis, it was necessary to avoid conditions which co-extract the N-oxide in the sample preparation so as to assure no contribution of artifactual products from DMAP N-oxide in the detection of the other compounds. For confirmation of the satisfactory separation of DMAP N-oxide from the others, the internal standards used for quantification were labeled with different numbers of deuterium atoms. Determination of unchanged DMAP was performed without any derivatization, that of DMAP N-oxide was carried out after conversion into trifluoroacetyl-MA by reaction with trifluoroacetic anhydride, and MA and AP were quantified after trifluoroacetyl-derivatization. After intraperitoneal administration of DMAP HCI to pigmented hairy rats (5 mgkg(-1) day(-1), 10 days, n=3), concentrations of DMAP and its metabolites in urine, plasma and hair were measured by GC-MS-SIM. The area under the concentration versus time curves (AUCs) of DMAP, DMAP N-oxide, MA and AP in the plasma were 397.2+/-97.5, 279.7+/-68.3, 18.4+/-1.2 and 15.9+/-2.2 microg min ml(-1), while their concentrations in the hair newly grown for 4 weeks after administration were 4.82+/-0.67. 0.45+/-0.09, 3.25+/-0.36 and 0.89+/-0.05 ng mg(-1), respectively. This fact suggested that the incorporation tendency of DMAP N-oxide from plasma into hair was distinctly low in comparison with the other compounds.
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Affiliation(s)
- R Kikura
- National Institute of Health Sciences, Setagaya, Tokyo, Japan.
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10
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Musshoff F. Illegal or legitimate use? Precursor compounds to amphetamine and methamphetamine. Drug Metab Rev 2000; 32:15-44. [PMID: 10711406 DOI: 10.1081/dmr-100100562] [Citation(s) in RCA: 80] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The interpretation of methamphetamine and amphetamine positive test results in biological samples is a challenge to clinical and forensic toxicology for several reasons. The effects of pH and dilution of urine samples and the knowledge about legitimate and illicit sources have to be taken into account. Besides a potentially legal prescription of amphetamines, many substances metabolize to methamphetamine or amphetamine in the body: amphetaminil, benzphetamine, clobenzorex, deprenyl, dimethylamphetamine, ethylamphetamine, famprofazone, fencamine, fenethylline, fenproporex, furfenorex, mefenorex, mesocarb, and prenylamine. Especially the knowledge of potential origins of methamphetamine and amphetamine turns out to be very important to prevent a misinterpretation of the surrounding circumstances and to prove illegal drug abuse. In this review, potential precursor compounds are described, including their medical use and major clinical effects and their metabolic profiles, as well as some clues which help to identify the sources.
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Affiliation(s)
- F Musshoff
- Institute of Legal Medicine, Rheinische Friedrich-Wilhelms-University, Bonn, Germany
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