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Phillips HN, Tormoehlen L. Toxin-Induced Seizures ∗Adapted from “Toxin-Induced Seizures” in Neurologic Clinics, November 2020. Emerg Med Clin North Am 2022; 40:417-430. [DOI: 10.1016/j.emc.2022.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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2
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Welz A, Koba M, Kośliński P, Siódmiak J. Comparison of LC-MS and LC-DAD Methods of Detecting Abused Piperazine Designer Drugs. J Clin Med 2022; 11:jcm11071758. [PMID: 35407366 PMCID: PMC8999770 DOI: 10.3390/jcm11071758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/17/2022] [Accepted: 03/19/2022] [Indexed: 12/10/2022] Open
Abstract
Recreational use of piperazine designer drugs is a serious threat to human health. These compounds act on the body in a similar fashion to illegal drugs. They induce psychostimulatory effects as well as visual and auditory hallucinations to varying degrees. In many cases of poisoning and deaths, the presence of two or even several psychoactive substances have been demonstrated. Piperazine derivatives are often found in such mixtures and pose a great analytical problem during their identification. Additionally, some piperazine derivatives can be detected in biological material as a result of metabolic changes to related drugs. Therefore, it is necessary to correctly identify these compounds and ensure repeatability of determinations. This article presents a comparison of the methods used to detect abused piperazine designer drugs using liquid chromatography in combination with a diode-array detector (LC-DAD) or mass spectrometer (LC-MS). Each of methods can be used independently for determinations, obtaining reliable results in a short time of analysis. These methods can also complement each other, providing qualitative and quantitative confirmation of results. The proposed methods provide analytical confirmation of poisoning and may be helpful in toxicological diagnostics.
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Affiliation(s)
- Anna Welz
- Department of Toxicology and Bromatology, Faculty of Pharmacy, Collegium Medicum Nicolaus Copernicus University, 85-089 Bydgoszcz, Poland; (M.K.); (P.K.)
- Correspondence:
| | - Marcin Koba
- Department of Toxicology and Bromatology, Faculty of Pharmacy, Collegium Medicum Nicolaus Copernicus University, 85-089 Bydgoszcz, Poland; (M.K.); (P.K.)
| | - Piotr Kośliński
- Department of Toxicology and Bromatology, Faculty of Pharmacy, Collegium Medicum Nicolaus Copernicus University, 85-089 Bydgoszcz, Poland; (M.K.); (P.K.)
| | - Joanna Siódmiak
- Department of Laboratory Diagnostics, Faculty of Pharmacy, Collegium Medicum Nicolaus Copernicus University, 85-094 Bydgoszcz, Poland;
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Rapid Targeted Method of Detecting Abused Piperazine Designer Drugs. J Clin Med 2021; 10:jcm10245813. [PMID: 34945109 PMCID: PMC8704057 DOI: 10.3390/jcm10245813] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/08/2021] [Accepted: 12/09/2021] [Indexed: 01/24/2023] Open
Abstract
Piperazine derivatives belong to the popular psychostimulating compounds from the group of designer drugs. They are an alternative to illegal drugs such as ecstasy and amphetamines. They are being searched by consumers for recreational use due to their stimulating and hallucinogenic effects. Many NPS-related poisonings and deaths have been reported where piperazines have been found. However, a major problem is the potential lack of laboratory confirmation of the involvement of piperazine derivatives in the occurrence of poisoning. Although many methods have been published, piperazine derivatives are not always included in a routine analytical approach or targeted toxicological analysis. There is an increasing need to provide qualitative evidence for the presence of piperazine derivatives and to ensure reproducible quantification. This article describes a new rapid method of detecting piperazine derivatives in biological material, using LC-MS. All target analytes were separated in a 15 min run time and identified based on the precursor ion, at least two product ions, and the retention time. Stable isotopically labeled (SIL) internal standards: BZP-D7, mCPP-D8 and TFMPP-D4 were used for analysis, obtaining the highest level of confidence in the results. The proposed detection method provides the analytical confirmation of poisoning with piperazine designer drugs.
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Silva WP, Rocha RG, Arantes LC, Lima CD, Melo LMA, Munoz RAA, Dos Santos WTP, Richter EM. Development of a simple and rapid screening method for the detection of 1-(3-chlorophenyl)piperazine in forensic samples. Talanta 2021; 233:122597. [PMID: 34215085 DOI: 10.1016/j.talanta.2021.122597] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/25/2021] [Accepted: 06/04/2021] [Indexed: 11/29/2022]
Abstract
1-(3-chlorophenyl) piperazine (mCPP) is a synthetic drug with hallucinogenic effects that has often been found in seized samples. In this context, easy to use point-of-care tests can be of great value in preliminary forensic analysis. Herein, we proposed a simple, fast, and portable electrochemical method for the detection of mCPP in seized samples. The method is based on the use of disposable screen-printed carbon electrodes (SPCE) and rapid screening procedures by square-wave voltammetry using minimal sample sizes (100 μL). mCPP showed an irreversible electrochemical oxidation process at +0.65 V on SPCE (vs Ag) using 0.04 mol L-1 Britton Robinson (BR) buffer solution (pH 7) as the supporting electrolyte. The proposed method exhibited a linear correlation (r = 0.998) between peak current and mCPP concentration in the range of 1-30 μmol L-1 (LOD = 0.1 μmol L-1). Interference studies were performed for adulterants and other classes of drugs of abuse, which can also be found in seized samples containing mCPP, such as caffeine, amphetamine, methamphetamine, 1-benzylpiperazine, 3,4-methylenedioxymethamphetamine, methylone, mephedrone, ethylone and 3, 4-methylenedioxypyrovalerone. The developed method presents great potential as a rapid and simple screening tool to detect mCPP in forensic samples.
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Affiliation(s)
- Weberson P Silva
- Institute of Chemistry, Federal University of Uberlandia, Uberlândia, Minas Gerais, 38400-092, Brazil
| | - Raquel G Rocha
- Institute of Chemistry, Federal University of Uberlandia, Uberlândia, Minas Gerais, 38400-092, Brazil
| | - Luciano C Arantes
- Seção de Perícias e Análises Laboratoriais, Instituto de Criminalística, Polícia Civil do Distrito Federal, Brasília, DF, 70610-970, Brazil
| | - Camila D Lima
- Departament of Chemistry, Federal University of Vales Do Jequitinhonha e Mucuri, Campus JK, Diamantina, MG, 39100-000, Brazil
| | - Larissa M A Melo
- Departament of Chemistry, Federal University of Vales Do Jequitinhonha e Mucuri, Campus JK, Diamantina, MG, 39100-000, Brazil
| | - Rodrigo A A Munoz
- Institute of Chemistry, Federal University of Uberlandia, Uberlândia, Minas Gerais, 38400-092, Brazil
| | - Wallans T P Dos Santos
- Departament of Pharmacy, Federal University of Vales Do Jequitinhonha e Mucuri, Campus JK, Diamantina, MG, 39100-000, Brazil.
| | - Eduardo M Richter
- Institute of Chemistry, Federal University of Uberlandia, Uberlândia, Minas Gerais, 38400-092, Brazil.
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5
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Rocha RG, Silva IC, Arantes LC, Stefano JS, Lima CD, Melo LM, Munoz RA, dos Santos WT, Richter EM. Simple and rapid electrochemical detection of 1-benzylpiperazine on carbon screen-printed electrode. Microchem J 2021. [DOI: 10.1016/j.microc.2021.106282] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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6
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Overview of the major classes of new psychoactive substances, psychoactive effects, analytical determination and conformational analysis of selected illegal drugs. OPEN CHEM 2021. [DOI: 10.1515/chem-2021-0196] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Abstract
The misuse of psychoactive substances is attracting a great deal of attention from the general public. An increase use of psychoactive substances is observed among young people who do not have enough awareness of the harmful effects of these substances. Easy access to illicit drugs at low cost and lack of effective means of routine screening for new psychoactive substances (NPS) have contributed to the rapid increase in their use. New research and evidence suggest that drug use can cause a variety of adverse psychological and physiological effects on human health (anxiety, panic, paranoia, psychosis, and seizures). We describe different classes of these NPS drugs with emphasis on the methods used to identify them and the identification of their metabolites in biological specimens. This is the first review that thoroughly gives the literature on both natural and synthetic illegal drugs with old known data and very hot new topics and investigations, which enables the researcher to use it as a starting point in the literature exploration and planning of the own research. For the first time, the conformational analysis was done for selected illegal drugs, giving rise to the search of the biologically active conformations both theoretically and using lab experiments.
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Abstract
New toxins are emerging all the time. In this article, the authors review common toxins that cause seizure, their mechanisms, associated toxidromes, and treatments. Stimulants, cholinergic agents, gamma-aminobutyric acid antagonists, glutamate agonists, histamine and adenosine antagonists, and withdrawal states are highlighted. Understanding current mechanisms for common toxin-induced seizures can promote understanding for future toxins and predicting if seizure may occur as a result of toxicity.
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Affiliation(s)
- Haley N Phillips
- Department of Neurology, Indiana University, Indiana University Neuroscience Center, 355 West 16th Street, Suite 4700, Indianapolis, IN 46202, USA.
| | - Laura Tormoehlen
- Department of Neurology, Indiana University, Indiana University Neuroscience Center, 355 West 16th Street, Suite 4700, Indianapolis, IN 46202, USA; Department of Emergency Medicine-Toxicology, Indiana University, Indiana University Neuroscience Center, 355 West 16th Street, Suite 4700, Indianapolis, IN 46202, USA
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Luethi D, Liechti ME. Designer drugs: mechanism of action and adverse effects. Arch Toxicol 2020; 94:1085-1133. [PMID: 32249347 PMCID: PMC7225206 DOI: 10.1007/s00204-020-02693-7] [Citation(s) in RCA: 125] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 02/25/2020] [Indexed: 12/18/2022]
Abstract
Psychoactive substances with chemical structures or pharmacological profiles that are similar to traditional drugs of abuse continue to emerge on the recreational drug market. Internet vendors may at least temporarily sell these so-called designer drugs without adhering to legal statutes or facing legal consequences. Overall, the mechanism of action and adverse effects of designer drugs are similar to traditional drugs of abuse. Stimulants, such as amphetamines and cathinones, primarily interact with monoamine transporters and mostly induce sympathomimetic adverse effects. Agonism at μ-opioid receptors and γ-aminobutyric acid-A (GABAA) or GABAB receptors mediates the pharmacological effects of sedatives, which may induce cardiorespiratory depression. Dissociative designer drugs primarily act as N-methyl-D-aspartate receptor antagonists and pose similar health risks as the medically approved dissociative anesthetic ketamine. The cannabinoid type 1 (CB1) receptor is thought to drive the psychoactive effects of synthetic cannabinoids, which are associated with a less desirable effect profile and more severe adverse effects compared with cannabis. Serotonergic 5-hydroxytryptamine-2A (5-HT2A) receptors mediate alterations of perception and cognition that are induced by serotonergic psychedelics. Because of their novelty, designer drugs may remain undetected by routine drug screening, thus hampering evaluations of adverse effects. Intoxication reports suggest that several designer drugs are used concurrently, posing a high risk for severe adverse effects and even death.
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Affiliation(s)
- Dino Luethi
- Center for Physiology and Pharmacology, Institute of Pharmacology, Medical University of Vienna, Währinger Strasse 13a, 1090, Vienna, Austria.
- Institute of Applied Physics, Vienna University of Technology, Getreidemarkt 9, 1060, Vienna, Austria.
- Division of Clinical Pharmacology and Toxicology, University Hospital Basel and University of Basel, Schanzenstrasse 55, 4056, Basel, Switzerland.
| | - Matthias E Liechti
- Division of Clinical Pharmacology and Toxicology, University Hospital Basel and University of Basel, Schanzenstrasse 55, 4056, Basel, Switzerland.
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Lee JH, Park HN, Kim NS, Park S, Lee YM, Kang H. Development of a specific fragmentation pattern-based quadrupole-Orbitrap™ mass spectrometry method to screen drugs in illicit products. Sci Justice 2020; 60:86-94. [DOI: 10.1016/j.scijus.2019.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 07/23/2019] [Accepted: 08/11/2019] [Indexed: 12/29/2022]
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Souto C, Göethel G, Peruzzi CP, Cestonaro LV, Garcia I, Ávila DS, Eifler‐Lima V, Carmo H, Bastos MDL, Garcia SC, Arbo MD. Piperazine designer drugs elicit toxicity in the alternative in vivo model
Caenorhabditis elegans. J Appl Toxicol 2019; 40:363-372. [DOI: 10.1002/jat.3909] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 09/06/2019] [Indexed: 12/17/2022]
Affiliation(s)
- Caroline Souto
- Laboratório de Toxicologia (LATOX), Departamento de Análises, Faculdade de FarmáciaUniversidade Federal do Rio Grande do Sul (UFRGS) Porto Alegre RS Brazil
| | - Gabriela Göethel
- Laboratório de Toxicologia (LATOX), Departamento de Análises, Faculdade de FarmáciaUniversidade Federal do Rio Grande do Sul (UFRGS) Porto Alegre RS Brazil
- Programa de Pós‐Graduação em Ciências Farmacêuticas, Faculdade de FarmáciaUniversidade Federal do Rio Grande do Sul (UFRGS) Porto Alegre RS Brazil
| | - Caroline Portela Peruzzi
- Laboratório de Toxicologia (LATOX), Departamento de Análises, Faculdade de FarmáciaUniversidade Federal do Rio Grande do Sul (UFRGS) Porto Alegre RS Brazil
- Programa de Pós‐Graduação em Ciências Farmacêuticas, Faculdade de FarmáciaUniversidade Federal do Rio Grande do Sul (UFRGS) Porto Alegre RS Brazil
| | - Larissa Vivan Cestonaro
- Laboratório de Toxicologia (LATOX), Departamento de Análises, Faculdade de FarmáciaUniversidade Federal do Rio Grande do Sul (UFRGS) Porto Alegre RS Brazil
- Programa de Pós‐Graduação em Ciências Farmacêuticas, Faculdade de FarmáciaUniversidade Federal do Rio Grande do Sul (UFRGS) Porto Alegre RS Brazil
| | - Ingrid Garcia
- Laboratório de Toxicologia (LATOX), Departamento de Análises, Faculdade de FarmáciaUniversidade Federal do Rio Grande do Sul (UFRGS) Porto Alegre RS Brazil
| | - Daiana Silva Ávila
- Grupo de Pesquisa em Bioquímica e Toxicologia em Caenorhabditis elegans (GBToxCE)Universidade Federal do Pampa (UNIPAMPA) Uruguaiana RS Brazil
| | - Vera Eifler‐Lima
- Programa de Pós‐Graduação em Ciências Farmacêuticas, Faculdade de FarmáciaUniversidade Federal do Rio Grande do Sul (UFRGS) Porto Alegre RS Brazil
- Laboratório de Síntese Orgânica Medicinal (LaSOM), Departamento de Produção de Matéria Prima, Faculdade de FarmáciaUniversidade Federal do Rio Grande do Sul (UFRGS) Porto Alegre RS Brazil
| | - Helena Carmo
- UCIBIO/REQUIMTE, Laboratório de Toxicologia, Departamento de Ciências Biológicas, Faculdade de FarmáciaUniversidade do Porto Porto Portugal
| | - Maria de Lurdes Bastos
- UCIBIO/REQUIMTE, Laboratório de Toxicologia, Departamento de Ciências Biológicas, Faculdade de FarmáciaUniversidade do Porto Porto Portugal
| | - Solange C. Garcia
- Laboratório de Toxicologia (LATOX), Departamento de Análises, Faculdade de FarmáciaUniversidade Federal do Rio Grande do Sul (UFRGS) Porto Alegre RS Brazil
- Programa de Pós‐Graduação em Ciências Farmacêuticas, Faculdade de FarmáciaUniversidade Federal do Rio Grande do Sul (UFRGS) Porto Alegre RS Brazil
| | - Marcelo Dutra Arbo
- Laboratório de Toxicologia (LATOX), Departamento de Análises, Faculdade de FarmáciaUniversidade Federal do Rio Grande do Sul (UFRGS) Porto Alegre RS Brazil
- Programa de Pós‐Graduação em Ciências Farmacêuticas, Faculdade de FarmáciaUniversidade Federal do Rio Grande do Sul (UFRGS) Porto Alegre RS Brazil
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Majrashi M, Almaghrabi M, Fadan M, Fujihashi A, Lee W, Deruiter J, Randall Clark C, Dhanasekaran M. Dopaminergic neurotoxic effects of 3-TFMPP derivatives. Life Sci 2018; 209:357-369. [PMID: 30067941 DOI: 10.1016/j.lfs.2018.07.052] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 07/26/2018] [Accepted: 07/27/2018] [Indexed: 12/18/2022]
Abstract
Designer drugs are synthetically formulated to mimic the psychostimulatory effects of an original controlled/illegal drug of abuse. Designer drugs have similar chemical structure or functional analog as compared to existing controlled psychostimulatory drugs. There is a substantial rise in the production and use of designer drugs globally. Piperazine designer drugs were synthesized as an alternative to MDMA and have shown to induce numerous toxic effects leading to huge health, safety, law enforcement & monetary problems, and lethality. Currently, there are very few studies on the dopaminergic neurotoxicity of 1-(3-trifluoromethylphenyl) piperazine (3-TFMPP) and its derivatives (structural congeners). N27 rat dopaminergic neurons are valid cells to investigate the neurotoxic effects and establish the neurotoxic mechanisms of various substances. In the current study, we studied the time and dose-dependent neurotoxicity mechanisms of dopaminergic neurotoxicity of 3-TFMPP (parent compound) and its derivatives (2-TFMPP, 4-TFMPP). TFMPP derivatives-induced significant neurotoxicity (induced dopaminergic neuronal death. TFMPP derivatives-induced oxidative stress, mitochondrial dysfunction, apoptosis and decreased tyrosine hydroxylase expression. If the use of designer drugs are not strictly regulated and restricted around the world, this can lead to numerous central and peripheral disorders leading to a liability to the current and future society.
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Affiliation(s)
- Mohammed Majrashi
- Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, AL, USA; Department of Pharmacology, Faculty of Medicine, University of Jeddah, Jeddah, 23881, Saudi Arabia
| | - Mohammed Almaghrabi
- Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, AL, USA; Department of Medicinal Chemistry, Faculty of Pharmacy, Taibah University, AL Medina, KSA
| | - Maali Fadan
- Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, AL, USA
| | - Ayaka Fujihashi
- Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, AL, USA
| | - Wooseok Lee
- Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, AL, USA
| | - Jack Deruiter
- Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, AL, USA
| | - C Randall Clark
- Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, AL, USA
| | - Muralikrishnan Dhanasekaran
- Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, AL, USA.
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Abstract
Several novel psychoactive substances have emerged in recent years. Users are typically young men who use other substances. In the category of stimulants, cathinones ("bath salts") have predominated and can lead to agitation, psychosis, hyperthermia, and death. Synthetic cannabinoids ("spice") are more potent than marijuana and can lead to agitation, psychosis, seizures, and death. There are no rapid tests to identify these substances and general treatment includes benzodiazepines for agitation and supportive therapy. Many Synthetic opioids are potent analogues of fentanyl and carry a high risk of overdose. In addition, there are several designer benzodiazepines that have emerged.
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Affiliation(s)
- Ryan Graddy
- Division of Chemical Dependence, Johns Hopkins University School of Medicine, 5200 Eastern Avenue, Suite D5W, Baltimore, MD 21224, USA
| | - Megan E Buresh
- Division of Chemical Dependence, Johns Hopkins University School of Medicine, 5200 Eastern Avenue, Suite D5W, Baltimore, MD 21224, USA
| | - Darius A Rastegar
- Division of Chemical Dependence, Johns Hopkins University School of Medicine, 5200 Eastern Avenue, Suite D5W, Baltimore, MD 21224, USA.
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Dolan SB, Shetty RA, Forster MJ, Gatch MB. Impure but not inactive: Behavioral pharmacology of dibenzylpiperazine, a common by-product of benzylpiperazine synthesis. J Psychopharmacol 2018; 32:802-810. [PMID: 29909719 PMCID: PMC7504971 DOI: 10.1177/0269881118780613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Substituted piperazines comprise a substantial proportion of the novel psychoactive substance market. Among the most widely abused piperazine compounds are meta-chlorophenylpiperazine (mCPP), tri-fluoromethylphenylpiperazine (TFMPP), and, especially, benzylpiperazine (BZP), which are commonly incorporated, either alone or in combination, in illicit "party pills" or "ecstasy" formulations. Illicit synthesis of BZP often results in production of an impure by-product dibenzylpiperazine (DBZP), which frequently appears alongside BZP in these formulations; however, despite its ubiquity, little information exists regarding the abuse liability of DBZP. AIMS The current study aimed to evaluate the abuse-related behavioral pharmacology of DBZP. METHODS DBZP, mCPP, and TFMPP were tested in parallel in mice in locomotor activity and conditioned place preference assays, and in a drug discrimination assay with rats trained to discriminate either methamphetamine, cocaine, (±)-3,4-methylenedioxymethamphetamine (MDMA), or -2,5-dimethoxy-4-methylamphetamine(DOM). RESULTS Each of the compounds tested produced dose-dependent decreases in locomotor activity. DBZP substituted fully for methamphetamine, produced subthreshold drug-appropriate responding for cocaine and MDMA, and failed to substitute for DOM. Conversely, TFMPP and mCPP only produced subthreshold drug-appropriate responding for methamphetamine and MDMA, respectively, and both compounds failed to substitute for cocaine or DOM. None of the compounds tested produced a place preference. DBZP produced convulsions in rats at the highest dose tested. CONCLUSIONS These data indicate that DBZP is more similar to BZP, albeit with lower potency and efficacy, than its serotonergic piperazine counterparts, and is a behaviorally-active compound with some abuse liability and potential for adverse health effects.
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Affiliation(s)
- Sean B Dolan
- Pharmacology and Neuroscience, University of North Texas Health Science Center at Fort Worth, USA
| | - Ritu A Shetty
- Pharmacology and Neuroscience, University of North Texas Health Science Center at Fort Worth, USA
| | - Michael J Forster
- Pharmacology and Neuroscience, University of North Texas Health Science Center at Fort Worth, USA
| | - Michael B Gatch
- Pharmacology and Neuroscience, University of North Texas Health Science Center at Fort Worth, USA
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King A, Dimovska M, Bisoski L. Sympathomimetic Toxidromes and Other Pharmacological Causes of Acute Hypertension. Curr Hypertens Rep 2018; 20:8. [DOI: 10.1007/s11906-018-0807-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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15
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Hondebrink L, Zwartsen A, Westerink RHS. Effect fingerprinting of new psychoactive substances (NPS): What can we learn from in vitro data? Pharmacol Ther 2017; 182:193-224. [PMID: 29097307 DOI: 10.1016/j.pharmthera.2017.10.022] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The use of new psychoactive substances (NPS) is increasing and currently >600 NPS have been reported. However, limited information on neuropharmacological and toxicological effects of NPS is available, hampering risk characterization. We reviewed the literature on the in vitro neuronal modes of action to obtain effect fingerprints of different classes of illicit drugs and NPS. The most frequently reported NPS were selected for review: cathinones (MDPV, α-PVP, mephedrone, 4-MEC, pentedrone, methylone), cannabinoids (JWH-018), (hallucinogenic) phenethylamines (4-fluoroamphetamine, benzofurans (5-APB, 6-APB), 2C-B, NBOMes (25B-NBOMe, 25C-NBOMe, 25I-NBOMe)), arylcyclohexylamines (methoxetamine) and piperazine derivatives (mCPP, TFMPP, BZP). Our effect fingerprints highlight the main modes of action for the different NPS studied, including inhibition and/or reversal of monoamine reuptake transporters (cathinones and non-hallucinogenic phenethylamines), activation of 5-HT2receptors (hallucinogenic phenethylamines and piperazines), activation of cannabinoid receptors (cannabinoids) and inhibition of NDMA receptors (arylcyclohexylamines). Importantly, we identified additional targets by relating reported effect concentrations to the estimated human brain concentrations during recreational use. These additional targets include dopamine receptors, α- and β-adrenergic receptors, GABAAreceptors and acetylcholine receptors, which may all contribute to the observed clinical symptoms following exposure. Additional data is needed as the number of NPS continues to increase. Also, the effect fingerprints we have obtained are still incomplete and suffer from a large variation in the reported effects and effect sizes. Dedicated in vitro screening batteries will aid in complementing specific effect fingerprints of NPS. These fingerprints can be implemented in the risk assessments of NPS that are necessary for eventual control measures to reduce Public Health risks.
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Affiliation(s)
- Laura Hondebrink
- Dutch Poisons Information Center (DPIC), University Medical Center Utrecht, Utrecht University, The Netherlands
| | - Anne Zwartsen
- Dutch Poisons Information Center (DPIC), University Medical Center Utrecht, Utrecht University, The Netherlands; Neurotoxicology Research Group, Division Toxicology, Institute for Risk Assessment Sciences (IRAS), Faculty of Veterinary Medicine, Utrecht University, P.O. Box 80.177, NL-3508 TD, Utrecht, The Netherlands
| | - Remco H S Westerink
- Neurotoxicology Research Group, Division Toxicology, Institute for Risk Assessment Sciences (IRAS), Faculty of Veterinary Medicine, Utrecht University, P.O. Box 80.177, NL-3508 TD, Utrecht, The Netherlands.
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16
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Taylor NJ, Emer E, Preshlock S, Schedler M, Tredwell M, Verhoog S, Mercier J, Genicot C, Gouverneur V. Derisking the Cu-Mediated 18F-Fluorination of Heterocyclic Positron Emission Tomography Radioligands. J Am Chem Soc 2017; 139:8267-8276. [PMID: 28548849 DOI: 10.1021/jacs.7b03131] [Citation(s) in RCA: 138] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Molecules labeled with fluorine-18 (18F) are used in positron emission tomography to visualize, characterize and measure biological processes in the body. Despite recent advances in the incorporation of 18F onto arenes, the development of general and efficient approaches to label radioligands necessary for drug discovery programs remains a significant task. This full account describes a derisking approach toward the radiosynthesis of heterocyclic positron emission tomography (PET) radioligands using the copper-mediated 18F-fluorination of aryl boron reagents with 18F-fluoride as a model reaction. This approach is based on a study examining how the presence of heterocycles commonly used in drug development affects the efficiency of 18F-fluorination for a representative aryl boron reagent, and on the labeling of more than 50 (hetero)aryl boronic esters. This set of data allows for the application of this derisking strategy to the successful radiosynthesis of seven structurally complex pharmaceutically relevant heterocycle-containing molecules.
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Affiliation(s)
- Nicholas J Taylor
- University of Oxford , Chemistry Research Laboratory, 12 Mansfield Road, Oxford OX1 3TA, U.K
| | - Enrico Emer
- University of Oxford , Chemistry Research Laboratory, 12 Mansfield Road, Oxford OX1 3TA, U.K
| | - Sean Preshlock
- University of Oxford , Chemistry Research Laboratory, 12 Mansfield Road, Oxford OX1 3TA, U.K
| | - Michael Schedler
- University of Oxford , Chemistry Research Laboratory, 12 Mansfield Road, Oxford OX1 3TA, U.K
| | - Matthew Tredwell
- University of Oxford , Chemistry Research Laboratory, 12 Mansfield Road, Oxford OX1 3TA, U.K
| | - Stefan Verhoog
- University of Oxford , Chemistry Research Laboratory, 12 Mansfield Road, Oxford OX1 3TA, U.K
| | - Joel Mercier
- UCB Biopharma SPRL , 1420 Braine-L'Alleud, Belgium
| | | | - Véronique Gouverneur
- University of Oxford , Chemistry Research Laboratory, 12 Mansfield Road, Oxford OX1 3TA, U.K
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Desomorphine (Krokodil): An overview of its chemistry, pharmacology, metabolism, toxicology and analysis. Drug Alcohol Depend 2017; 173:59-68. [PMID: 28199917 DOI: 10.1016/j.drugalcdep.2016.12.021] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 11/09/2016] [Accepted: 12/13/2016] [Indexed: 12/14/2022]
Abstract
BACKGROUND "Krokodil" or "Crocodile" is an illegal homemade desomorphine drug obtained from chemical reactions of commercial codeine drugs with several other powerful and highly toxic chemical agents increasing its addiction and hallucinogenic effects when compared with other morphine analogues. METHODS This paper summarizes a complete review about an old drug called desomorphine (Krokodil), presenting its chemistry, pharmacology, metabolism, toxicology and analysis. RESULTS It is of particular interest and concern because this cheaper injectable semisynthetic opioid drug has been largely used in recent years for recreational purposes in several Eastern European as well as North and South American countries, despite known damage to health that continuous use might induce. These injuries are much stronger and more aggressive than morphine's, infecting and rotting skin and soft tissue to the bone of addicts at the point of injection in less than three years, which, in most cases, evolves to death. On this basis, it is imperative that literature reviews focus on the chemistry, pharmacology, toxicology and analysis of dangerous Krokodil to find strategies for rapid and effective determination to mitigate its adverse effects on addicts and prevent consumption. CONCLUSIONS It is crucial to know the symptoms and consequences of the use of Krokodil, as well as METHODS: for identification and quantification of desomorphine, contaminants and metabolites, which can help the forensic work of diagnosis and propose actions to control and eradicate this great danger to public health around the world.
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Katz DP, Deruiter J, Bhattacharya D, Ahuja M, Bhattacharya S, Clark CR, Suppiramaniam V, Dhanasekaran M. Benzylpiperazine: "A messy drug". Drug Alcohol Depend 2016; 164:1-7. [PMID: 27207154 DOI: 10.1016/j.drugalcdep.2016.04.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 04/01/2016] [Accepted: 04/03/2016] [Indexed: 01/02/2023]
Abstract
Designer drugs are synthetic structural analogues/congeners of controlled substances with slightly modified chemical structures intended to mimic the pharmacological effects of known drugs of abuse so as to evade drug classification. Benzylpiperazine (BZP), a piperazine derivative, elevates synaptic dopamine and serotonin levels producing stimulatory and hallucinogenic effects, respectively, similar to the well-known drug of abuse, methylenedioxymethamphetamine (MDMA). Furthermore, BZP augments the release of norepinephrine by inhibiting presynaptic autoreceptors, therefore, BZP is a "messy drug" due to its multifaceted regulation of synaptic monoamine neurotransmitters. Initially, pharmaceutical companies used BZP as a therapeutic drug for the treatment of various disease states, but due to its contraindications and abuse potential it was withdrawn from the market. BZP imparts predominately sympathomimetic effects accompanied by serious cardiovascular implications. Addictive properties of BZP include behavioral sensitization, cross sensitization, conditioned place preference and repeated self-administration. Additional testing of piperazine derived drugs is needed due to a scarcity of toxicological data and widely abuse worldwide.
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Affiliation(s)
- D P Katz
- Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, AL 36849, United States.
| | - J Deruiter
- Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, AL 36849, United States.
| | - D Bhattacharya
- Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, AL 36849, United States.
| | - M Ahuja
- Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, AL 36849, United States.
| | - S Bhattacharya
- Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, AL 36849, United States.
| | - C R Clark
- Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, AL 36849, United States.
| | - V Suppiramaniam
- Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, AL 36849, United States.
| | - M Dhanasekaran
- Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, AL 36849, United States.
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Persona K, Polus A, Góralska J, Gruca A, Dembińska-Kieć A, Piekoszewski W. An In Vitro Study of the Neurotoxic Effects of N-Benzylpiperazine: A Designer Drug of Abuse. Neurotox Res 2016; 29:558-68. [PMID: 26861955 PMCID: PMC4820481 DOI: 10.1007/s12640-016-9604-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 01/11/2016] [Accepted: 01/27/2016] [Indexed: 01/26/2023]
Abstract
Recently, the number of new psychoactive substances has significantly increased. Despite the systematic introduction of prohibition in trade of medicinal products which mimic the effects of illegal drugs, the problem concerning this group of drugs is still important although knowledge about the mechanism of action of those types of substances is scarce. This study aimed to follow the neurotoxic effect of N-benzylpiperazine (BZP), the central nervous system psychostimulant, using the human cancer LN-18 cell model. The statistically significant elevation of LDH levels, increased mitochondrial membrane potential, decreased ATP and increased ROS production, increased levels of DNA damage marker (8-OHdG) and activation of caspases: -3 and -9 confirmed by Real-Time PCR imply the activation of mitochondrial proapoptotic pathways induced by BZP after 24 h incubation. This study is a novel, preliminary attempt to explain the toxicity of one of the most popular designer drug of abuse at the cellular level.
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Affiliation(s)
- Karolina Persona
- Department of Analytical Chemistry, Faculty of Chemistry, Jagiellonian University in Krakow, Ingardena 3, 30-060, Kraków, Poland
| | - Anna Polus
- Department of Clinical Biochemistry, Jagiellonian University in Krakow - Medical College, Kraków, Poland
| | - Joanna Góralska
- Department of Clinical Biochemistry, Jagiellonian University in Krakow - Medical College, Kraków, Poland
| | - Anna Gruca
- Department of Clinical Biochemistry, Jagiellonian University in Krakow - Medical College, Kraków, Poland
| | - Aldona Dembińska-Kieć
- Department of Clinical Biochemistry, Jagiellonian University in Krakow - Medical College, Kraków, Poland
| | - Wojciech Piekoszewski
- Department of Analytical Chemistry, Faculty of Chemistry, Jagiellonian University in Krakow, Ingardena 3, 30-060, Kraków, Poland.
- School of Biomedicine, Far Eastern Federal University, Vladivostok, Russia.
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Hepatotoxicity of piperazine designer drugs: up-regulation of key enzymes of cholesterol and lipid biosynthesis. Arch Toxicol 2016; 90:3045-3060. [DOI: 10.1007/s00204-016-1665-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 01/06/2016] [Indexed: 12/12/2022]
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21
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Hondebrink L, Hermans EJ, Schmeink S, van Kleef RG, Meulenbelt J, Westerink RH. Structure-dependent inhibition of the human α 1 β 2 γ 2 GABA A receptor by piperazine derivatives: A novel mode of action. Neurotoxicology 2015; 51:1-9. [DOI: 10.1016/j.neuro.2015.09.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Revised: 09/02/2015] [Accepted: 09/02/2015] [Indexed: 10/23/2022]
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Identification and characterization of new designer drug 4-fluoro-PV9 and α-PHP in the seized materials. Forensic Toxicol 2015; 34:115-124. [PMID: 26793278 PMCID: PMC4705138 DOI: 10.1007/s11419-015-0295-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 09/21/2015] [Indexed: 11/23/2022]
Abstract
In this study, we present identification and physicochemical characterization of new cathinone derivatives, 4-fluoro-PV9 and already known α-PHP in seized materials. Although the disclosure of α-PHP from an illegal product had been reported and characterized to some extent, the data on α-PHP are also presented together with those of 4-fluoro-PV9. The data of characterization for the two compounds were obtained by high-performance liquid chromatography (HPLC)–mass spectrometry and HPLC–diode array detection, electrospray ionization/ion trap mass spectrometry in MS2 and MS3 modes, gas chromatography–mass spectrometry, thermogravimetric analysis, differential scanning calorimetry, Fourier transform infrared spectroscopy, ultraviolet-visible spectroscopy, and nuclear magnetic resonance spectroscopy. To our knowledge, this is the first report for identification and detailed characterization of 4-fluoro-PV9 circulated on the illegal drug market.
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Bonnici KS, Dargan PI, Wood DM. Novel psychoactive substances or ‘legal highs'. Br J Hosp Med (Lond) 2015; 76:C130-4. [DOI: 10.12968/hmed.2015.76.9.c130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Kathleen S Bonnici
- is Acute Medicine ST6 in the Department of Acute Medicine, Chelsea & Westminster Hospitals NHS Foundation Trust, London SW10 9NH
| | | | - David M Wood
- is Consultant Physician and Clinical Toxicologist in the Clinical Toxicology Department, St Thomas' Hospital, London
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Kuiper M, Hendrikx S, Koehler PJ. Headache and Tremor: Co-occurrences and Possible Associations. Tremor Other Hyperkinet Mov (N Y) 2015; 5:285. [PMID: 26175954 PMCID: PMC4472994 DOI: 10.7916/d8p55mkx] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Accepted: 05/12/2015] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Tremor and headache are two of the most prevalent neurological conditions. This review addresses possible associations between various types of tremor and headache, and provides a differential diagnosis for patients presenting with both tremor and headache. METHODS Data were identified by searching MEDLINE in February 2015, with the terms "tremor" and terms representing the primary headache syndromes. RESULTS Evidence for an association between migraine and essential tremor is conflicting. Other primary headaches are not associated with tremor. Conditions that may present with both tremor and headache include cervical dystonia, infectious diseases, hydrocephalus, spontaneous cerebrospinal fluid leaks, space-occupying lesions, and metabolic disease. Furthermore, both can be seen as a side effect of medication and in the use of recreational drugs. DISCUSSION No clear association between primary headaches and tremor has been found. Many conditions may feature both headache and tremor, but rarely as core clinical symptoms at presentation.
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Abstract
Fever is common in critically ill patients and the cause is frequently not infection. Drug fevers occur in the intensive care and there are many pharmacological agents, by a variety of mechanisms, which increase body temperature beyond normal range. This article is a review of the common classes of drugs that can induce hyperthermia, highlighting the deleterious effects of a sustained high temperature and outlining available treatments.
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Affiliation(s)
- Edward Walter
- Intensive Care Unit, Royal Surrey County Hospital, Guildford, Surrey, UK
| | - Mike Carraretto
- Intensive Care Unit, Royal Surrey County Hospital, Guildford, Surrey, UK
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The impact of the prohibition of benzylpiperazine (BZP) "legal highs" on the availability, price and strength of BZP in New Zealand. Drug Alcohol Depend 2014; 144:47-52. [PMID: 25213143 DOI: 10.1016/j.drugalcdep.2014.07.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Revised: 06/27/2014] [Accepted: 07/04/2014] [Indexed: 11/22/2022]
Abstract
BACKGROUND Legal highs containing benzylpiperazine (BZP) were widely sold in New Zealand until BZP was prohibited in 2008. We examined the impact the prohibition had on the availability and price of BZP over following years. METHODS Two national population surveys of BZP use were conducted in 2006 and 2009. Four annual targeted surveys of frequent drug users (FDU) were conducted from 2007-2010. Availability and price measures were obtained. Inflation-adjusted real retail prices were calculated. Other drug markets were monitored as quasi-controls. RESULTS The proportion of BZP users from the general population who considered the availability of BZP to be 'very easy' declined from 76% in 2006 to 21% in 2009. The proportion who thought BZP had become 'harder' to obtain increased from 5% in 2006 to 71% in 2009. The proportion who reported the price of BZP was 'higher' increased from 27% in 2006 to 51% in 2009. FDU who considered the availability of BZP to be 'very easy' declined from 98% in 2007 to 15% in 2008, and then increased to 42% by 2010. The real retail price of a BZP tablet increased from $9.86 in 2007 to $15.83 in 2010. The proportion who considered the price of BZP to be 'increasing' rose from 3% in 2007 to 47% in 2010. CONCLUSIONS The availability of BZP declined immediately following its prohibition. Availability recovered in subsequent years, but not to the pre-prohibition legal level. The price of BZP increased slowly over a number of years following the prohibition.
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Abstract
Health care providers are seeing an increased number of patients under the influence of several new psychoactive drug classes. Synthetic cannabinoids, cathinones, and piperazines are sought by users for their psychoactive effects, perceived safety profile, minimal legal regulations, and lack of detection on routine urine drug screening. However, these drugs are beginning to be recognized by the medical community for their toxic effects. The neuropsychiatric and cardiovascular toxicities are among the most common reasons for emergency medical treatment, which in some cases, can be severe and even life-threatening. Management strategies are often limited to supportive and symptomatic care due to the limited published data on alternative treatment approaches. The purpose of this article is to offer health care providers, emergency medical personnel in particular, an awareness and understanding of the dangers related to some of the new psychoactive drugs of abuse. The background, pharmacology, toxicity, management, detection, and legal status of each class will be discussed.
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Affiliation(s)
- Brian P. Kersten
- Pharmacy Department, Buffalo General Medical Center, Buffalo, NY, USA
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28
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Recent developments in urinalysis of metabolites of new psychoactive substances using LC–MS. Bioanalysis 2014; 6:2083-107. [DOI: 10.4155/bio.14.168] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
In the last decade, an ever-increasing number of new psychoactive substances (NPSs) have appeared on the recreational drug market. To account for this development, analytical toxicologists have to continuously adapt their methods to encompass the latest NPSs. Urine is the preferred biological matrix for screening analysis in different areas of analytical toxicology. However, the development of urinalysis procedures for NPSs is complicated by the fact that generally little or no information on urinary excretion patterns of such drugs exists when they first appear on the market. Metabolism studies are therefore a prerequisite in the development of urinalysis methods for NPSs. In this article, the literature on the urinalysis of NPS metabolites will be reviewed, focusing on articles published after 2008.
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Piperazine designer drugs induce toxicity in cardiomyoblast h9c2 cells through mitochondrial impairment. Toxicol Lett 2014; 229:178-89. [PMID: 24968061 DOI: 10.1016/j.toxlet.2014.06.031] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 06/18/2014] [Accepted: 06/20/2014] [Indexed: 12/28/2022]
Abstract
Abuse of synthetic drugs is widespread among young people worldwide. In this context, piperazine derived drugs recently appeared in the recreational drug market. Clinical studies and case-reports describe sympathomimetic effects including hypertension, tachycardia, and increased heart rate. Our aim was to investigate the cytotoxicity of N-benzylpiperazine (BZP), 1-(3-trifluoromethylphenyl) piperazine (TFMPP), 1-(4-methoxyphenyl) piperazine (MeOPP), and 1-(3,4-methylenedioxybenzyl) piperazine (MDBP) in the H9c2 rat cardiac cell line. Complete cytotoxicity curves were obtained at a 0-20 mM concentration range after 24 h incubations with each drug. The EC50 values (μM) were 343.9, 59.6, 570.1, and 702.5 for BZP, TFMPP, MeOPP, and MDBP, respectively. There was no change in oxidative stress markers. However, a decrease in total GSH content was noted for MDBP, probably due to metabolic conjugation reactions. All drugs caused significant decreases in intracellular ATP, accompanied by increased intracellular calcium levels and a decrease in mitochondrial membrane potential that seems to involve the mitochondrial permeability transition pore. The cell death mode revealed early apoptotic cells and high number of cells undergoing secondary necrosis. Among the tested drugs, TFMPP seems to be the most potent cytotoxic compound. Overall, piperazine designer drugs are potentially cardiotoxic and support concerns on risks associated with the intake of these drugs.
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Musselman ME, Hampton JP. "Not for human consumption": a review of emerging designer drugs. Pharmacotherapy 2014; 34:745-57. [PMID: 24710806 DOI: 10.1002/phar.1424] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Synthetic, or "designer" drugs, are created by manipulating the chemical structures of other psychoactive drugs so that the resulting product is structurally similar but not identical to illegal psychoactive drugs. Originally developed in the 1960s as a way to evade existing drug laws, the use of designer drugs has increased dramatically over the past few years. These drugs are deceptively packaged as "research chemicals," "incense," "bath salts," or "plant food," among other names, with labels that may contain warnings such as "not for human consumption" or "not for sale to minors." The clinical effects of most new designer drugs can be described as either hallucinogenic, stimulant, or opioid-like. They may also have a combination of these effects due to designer side-chain substitutions. The easy accessibility and rapid emergence of new designer drugs have created challenges for health care providers when treating patients presenting with acute toxicity from these substances, many of which can produce significant and/or life-threatening adverse effects. Moreover, the health care provider has no way to verify the contents and/or potency of the agent ingested because it can vary between packages and distributors. Therefore, a thorough knowledge of the available designer drugs, common signs and symptoms of toxicity associated with these agents, and potential effective treatment modalities are essential to appropriately manage these patients.
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Affiliation(s)
- Megan E Musselman
- Emergency Medicine/Critical Care, North Kansas City Hospital, Kansas City, Missouri
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Luciano RL, Perazella MA. Nephrotoxic effects of designer drugs: synthetic is not better! Nat Rev Nephrol 2014; 10:314-24. [PMID: 24662435 DOI: 10.1038/nrneph.2014.44] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Designer drugs are synthetic, psychoactive substances with similar structures and activity to existing scheduled drugs or controlled chemical compounds. The use of these drugs is not generally considered illegal and they cannot be detected using standard toxicology tests--essentially they are considered to be 'legal highs'. Over the past several years, increasing numbers of designer drugs have become available. These drugs are classified as amphetamine derivatives, phenylpiperazine derivatives, synthetic cathinones, synthetic cannabinoids, phencyclidine derivatives and synthetic opioids. Although euphoria is the desired effect, neuropsychiatric and cardiac manifestations are frequently observed in individuals using these drugs at high doses or using drugs that are contaminated with other substances. Some designer drugs are also associated with adverse renal effects, including acute kidney injury from pigment nephropathy, acute tubular necrosis, obstructive nephropathy and hyponatraemia. The misuse of these drugs should be recognized and clinicians made aware of the potential for acute nephrotoxicity as the health burden of these compounds increases.
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Affiliation(s)
- Randy L Luciano
- Department of Internal Medicine, Section of Nephrology, Yale University School of Medicine, BB 114, 330 Cedar Street, New Haven, CT 06520-8029, USA
| | - Mark A Perazella
- Department of Internal Medicine, Section of Nephrology, Yale University School of Medicine, BB 114, 330 Cedar Street, New Haven, CT 06520-8029, USA
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Simmler LD, Rickli A, Schramm Y, Hoener MC, Liechti ME. Pharmacological profiles of aminoindanes, piperazines, and pipradrol derivatives. Biochem Pharmacol 2014; 88:237-44. [PMID: 24486525 DOI: 10.1016/j.bcp.2014.01.024] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Revised: 01/17/2014] [Accepted: 01/17/2014] [Indexed: 11/25/2022]
Abstract
Aminoindanes, piperazines, and pipradrol derivatives are novel psychoactive substances found in "Ecstasy" tablets as replacements for 3,4-methylenedioxymethamphetamine (MDMA) or substances sold as "ivory wave." The pharmacology of these MDMA- and methylphenidate-like substances is poorly known. We characterized the pharmacology of the aminoindanes 5,6-methylenedioxy-2-aminoindane (MDAI), 5-iodoaminoindane (5-IAI), and 2-aminoindane (2-AI), the piperazines meta-chlorophenylpiperazine (m-CPP), trifluoromethylphenylpiperazine (TFMPP), and 1-benzylpiperazine (BZP), and the pipradrol derivatives desoxypipradrol (2-diphenylmethylpiperidine [2-DPMP]), diphenylprolinol (diphenyl-2-pyrrolidinemethanol [D2PM]), and methylphenidate. We investigated norepinephrine (NE), dopamine (DA), and serotonin (5-hydroxytryptamine [5-HT]) uptake inhibition using human embryonic kidney 293 (HEK 293) cells that express the respective human monoamine transporters (NET, DAT, and SERT). We also evaluated the drug-induced efflux of NE, DA, and 5-HT from monoamine-preloaded cells and the binding affinity to monoamine transporters and receptors, including trace amine-associated receptor 1 (TAAR1). 5-IAI and MDAI preferentially inhibited the SERT and NET and released 5-HT. 2-AI interacted with the NET. BZP blocked the NET and released DA. m-CPP and TFMPP interacted with the SERT and serotonergic receptors. The pipradrol derivatives were potent and selective catecholamine transporter blockers without substrate releasing properties. BZP, D2PM, and 2-DPMP lacked serotonergic activity and TAAR1 binding, in contrast to the aminoindanes and phenylpiperazines. In summary, all of the substances were monoamine transporter inhibitors, but marked differences were found in their DAT vs. SERT inhibition profiles, release properties, and receptor interactions. The pharmacological profiles of D2PM and 2-DPMP likely predict a high abuse liability.
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Affiliation(s)
- Linda D Simmler
- Psychopharmacology Research, Division of Clinical Pharmacology and Toxicology, Department of Biomedicine, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Anna Rickli
- Psychopharmacology Research, Division of Clinical Pharmacology and Toxicology, Department of Biomedicine, University Hospital Basel and University of Basel, Basel, Switzerland
| | - York Schramm
- Department of Chemistry, University of Basel, Basel, Switzerland
| | - Marius C Hoener
- Neuroscience Research, Pharmaceuticals Division, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - Matthias E Liechti
- Psychopharmacology Research, Division of Clinical Pharmacology and Toxicology, Department of Biomedicine, University Hospital Basel and University of Basel, Basel, Switzerland.
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Wilson B, Tavakoli H, DeCecchis D, Mahadev V. Synthetic Cannabinoids, Synthetic Cathinones, and Other Emerging Drugs of Abuse. Psychiatr Ann 2013. [DOI: 10.3928/00485713-20131206-08] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Chatterton CN, Jones GR, Singer PP. A Case of Fatal Benzylpiperazine (BZP) and Trifluoromethylphenylpiperazine (TFMPP) Toxicity. CANADIAN SOCIETY OF FORENSIC SCIENCE JOURNAL 2013. [DOI: 10.1080/00085030.2012.10757188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Herlich A. Perioperative temperature elevation: not all hyperthermia is malignant hyperthermia. Paediatr Anaesth 2013; 23:842-50. [PMID: 23890328 DOI: 10.1111/pan.12244] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/08/2013] [Indexed: 12/01/2022]
Abstract
OBJECTIVES The objective of this review is to assist the readers, anesthesiologists, intensivists, and emergency physicians in making a more accurate diagnosis of perioperative fever or hyperthermia and subsequently choose the proper course of treatment. AIM To identify the many sources of perioperative fever and after a more accurate differential diagnosis, select appropriate treatment options. Most anesthesiologists, intensivists, and emergency physicians are not familiar with an expansive differential of perioperative fever. This article attempts to expose these physicians to that differential diagnosis. BACKGROUND Much of the medical literature has anecdotal reports, small case series, or limited reviews of the possible sources of hyperthermia or fever. This is especially true of the anesthesia literature. RESULTS A literature search was performed which identified many possible common and uncommon sources of fever. Some of these sources are quite relevant to the anesthesiologist. Other sources had potential relevance in obscure cases.
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Affiliation(s)
- Andrew Herlich
- Department of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261, USA.
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St John-Smith P, McQueen D, Edwards L, Schifano F. Classical and novel psychoactive substances: rethinking drug misuse from an evolutionary psychiatric perspective. Hum Psychopharmacol 2013; 28:394-401. [PMID: 23881888 DOI: 10.1002/hup.2303] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2012] [Accepted: 02/04/2013] [Indexed: 11/08/2022]
Abstract
In this article, ontogenetic and phylogenetic causes of drug abuse and links to human emotional development are considered. Some evolutionary perspectives (e.g. that under certain conditions, consumption of otherwise toxic alkaloids may confer both physical and cultural advantages) are reviewed. As described in the 'mismatch theory', the capacity of the human genome to evolve defences against toxins has been outstripped by the pace of cultural change and technological development, such as purposeful fermentation of alcohol and more recently distillation of alcohol; purification and chemical manipulation of plant alkaloids; and the engineering of entirely novel psychoactive substances (NPS). The functions of the neurobiological substrates that mediate substance misuse and dependence are reviewed. Reasons are given why NPSs present greater cause for concern than plant-derived substances of abuse. We argue that evolutionary biology provides an important orientation for the research agenda in substance misuse.
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Affiliation(s)
- Paul St John-Smith
- Hertsmere Community Mental Health Team, Hertfordshire Partnership Foundation Trust, Borehamwood, UK.
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Monteiro MS, Bastos MDL, Guedes de Pinho P, Carvalho M. Update on 1-benzylpiperazine (BZP) party pills. Arch Toxicol 2013; 87:929-47. [DOI: 10.1007/s00204-013-1057-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Accepted: 04/03/2013] [Indexed: 10/26/2022]
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Wong GTC, Irwin MG. Poisoning with illicit substances: toxicology for the anaesthetist. Anaesthesia 2013; 68 Suppl 1:117-24. [PMID: 23210561 DOI: 10.1111/anae.12053] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The consumption of illicit substances represents a considerable threat to the health and wellbeing of particular sectors of our communities. Hospitalisation is sometimes required for the treatment of the direct toxic effects of the drugs as well as for injuries sustained while under their influence. Although poisoning with 'traditional' substances of abuse such as opioids, cocaine and cannabis still predominate in terms of numbers, the availability and use of new psychoactive substances are on the rise. These latter agents, some of which began life as failed pharmaceutical products, have enjoyed renewed status as recreational stimulants, entactogens or hallucinogens, properties that originally precluded them from legitimate use. These drugs may act by enhancing endogenous release of neurotransmitters, inhibiting their reuptake back into neurons or having direct effects on receptors, and may involve adrenergic, dopaminergic or serotonergic systems. The use of intravenous lipid emulsion for the symptomatic treatment of drug overdose has become a fertile ground for research and may hold promise as a non-specific treatment for poisoning with illicit substances. Dexmedetomidine, an α(2)-receptor agonist with a central sympatholytic effect, may be able to counteract the cardiovascular and central nervous system overstimulation that may accompany stimulant toxicity.
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Affiliation(s)
- G T C Wong
- Department of Anaesthesiology, University of Hong Kong, Hong Kong.
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Johnson RD, Botch-Jones SR. The stability of four designer drugs: MDPV, mephedrone, BZP and TFMPP in three biological matrices under various storage conditions. J Anal Toxicol 2013; 37:51-5. [PMID: 23325764 DOI: 10.1093/jat/bks138] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The analysis of designer drugs, including those in the synthetic cathinone and piperazine classes, may be complicated by the poor stability of these compounds in biological specimens. The stability of four of these compounds was investigated: 3,4-methylenedioxypyrovalerone, 4-methyl-N-methylcathinone (mephedrone), N-benzylpiperazine and 1-[3-(trifluoromethyl)phenyl]piperazine. Compound stability was monitored in three different biological matrices when each matrix was stored under three different conditions. These matrices and conditions included human whole blood, human serum and human urine, each stored at -20, 4 and 22°C for a period of 14 days in the dark in a sealed glass container. Analysis by liquid chromatography-tandem mass spectrometry was performed on Day 1 to establish the initial concentration for each drug in each specimen type, and then the samples were divided into three parts for storage under the various conditions. Analysis was performed in triplicate on Days 2, 4, 7 and 14 for each specimen type under each storage condition and the results were compared to those obtained on Day 1. Following analysis of the data, it became clear that mephedrone was not stable, and that care must be taken following specimen receipt to ensure minimal degradation.
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Affiliation(s)
- Robert D Johnson
- Tarrant County Medical Examiner's Office, 200 Feliks Gwozdz Pl., Fort Worth, TX 76104, USA.
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Screening of Stimulants Including Designer Drugs in Urine Using a Liquid Chromatography Tandem Mass Spectrometry System. J Anal Toxicol 2013; 37:64-73. [DOI: 10.1093/jat/bks091] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Min CR, Kim MJ, Park YJ, Kim HR, Lee SY, Chung KH, Oh SM. Estrogenic effects and their action mechanism of the major active components of party pill drugs. Toxicol Lett 2012; 214:339-47. [PMID: 23026265 DOI: 10.1016/j.toxlet.2012.09.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2012] [Revised: 09/17/2012] [Accepted: 09/19/2012] [Indexed: 11/26/2022]
Abstract
Benzylpiperazine (BZP) and trifluoromethylphenylpiperazine (TFMPP) are commonly used constituents of party pill drugs. They are reported to induce psychoactive effects such as euphoria and provide effects similar with other illicit drugs such as methylenedioxymethamphetamine (MDMA). A great deal of evidence has proven that party pills, as alternatives for MDMA, exert harmful effects on users. However, their toxicological effects have not been fully understood and endocrine disruptive effects are still unknown. In this study, we identified estrogenic effects of BZP and TFMPP by using in vitro and in vivo assays. BZP and TFMPP stimulated cell proliferation in a dose-dependent manner, while co-treatment with tamoxifen and BZP or TFMPP showed a decrease of E(2)-induced cell proliferation. In an estrogen sensitive reporter gene assay, BZP and TFMPP significantly increased transcriptional activities of party pill drugs. In addition, ER-related genes, PR and pS2, were significantly stimulated by BZP and TFMPP. These results indicated that BZP and TFMPP could have estrogenic activities related to the ER-mediated pathway. Unlike the in vitro assay results, BZP and TFMPP did not show significant effects on weight increase in a rodent uterotrophic assay. However, further studies would be necessary to verify the estrogenic activities of BZP and TFMPP by a chronic exposure animal study.
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Affiliation(s)
- Cho Rong Min
- School of Pharmacy, Sungkyunkwan University, 300 Cheoncheon dong, Jangan-gu, Suwon, Kyeonggi-do 440-746, South Korea
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Wood DM, Dargan PI. Use and acute toxicity associated with the novel psychoactive substances diphenylprolinol (D2PM) and desoxypipradrol (2-DPMP). Clin Toxicol (Phila) 2012; 50:727-32. [DOI: 10.3109/15563650.2012.716158] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Arbo MD, Bastos ML, Carmo HF. Piperazine compounds as drugs of abuse. Drug Alcohol Depend 2012; 122:174-85. [PMID: 22071119 DOI: 10.1016/j.drugalcdep.2011.10.007] [Citation(s) in RCA: 128] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2011] [Revised: 09/29/2011] [Accepted: 10/10/2011] [Indexed: 01/05/2023]
Abstract
Synthetic drugs are among the most commonly abused drugs in the world. This abuse is widespread among young people, especially in the dance club and rave scenes. Over the last several years, piperazine derived drugs have appeared, mainly available via the internet, and sold as ecstasy pills or under the names of "Frenzy", "Bliss", "Charge", "Herbal ecstasy", "A2", "Legal X" and "Legal E". Although in the market piperazine designer drugs have the reputation of being safe, several experimental and epidemiological studies indicate risks for humans. Piperazine designer drugs can be divided into two classes, the benzylpiperazines such as N-benzylpiperazine (BZP) and its methylenedioxy analogue 1-(3,4-methylenedioxybenzyl)piperazine (MDBP), and the phenylpiperazines such as 1-(3-chlorophenyl)piperazine (mCPP), 1-(3-trifluoromethylphenyl)piperazine (TFMPP), and 1-(4-methoxyphenyl)piperazine (MeOPP). Toxicokinetic properties, including metabolic pathways, actions and effects in animals and humans, with some hypothesis of mechanism of action, and analytical approaches for the identification of these drugs are summarized in this review.
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Affiliation(s)
- M D Arbo
- REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Portugal.
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BERNEY-MEYER LINDA, PUTT TRACEY, SCHOLLUM JOHN, WALKER ROBERT. Nephrotoxicity of recreational party drugs. Nephrology (Carlton) 2012; 17:99-103. [DOI: 10.1111/j.1440-1797.2011.01537.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Schep LJ, Slaughter RJ, Temple WA, Gee P. Comments on BZP and New Zealand's alternative approach to prohibition. Drug Test Anal 2011; 4:57; author reply 58. [PMID: 22012786 DOI: 10.1002/dta.356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2011] [Revised: 07/29/2011] [Accepted: 08/11/2011] [Indexed: 11/07/2022]
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