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3. List of Contributors

Author

Aas, M., primary, Abalo, R., additional, Abdel-Salam, O.M.E., additional, Abilio, V.C., additional, Adelli, G.R., additional, Ahmed, M.H., additional, Alhouayek, M., additional, Allen, J., additional, Allsop, D.J., additional, Almada, R.C., additional, Almeida, V., additional, Aloway, A., additional, Amanullah, S., additional, Ames, S.L., additional, Annaheim, B., additional, Appendino, G., additional, Aramaki, H., additional, Arias-Horcajadas, F., additional, Ariza, C., additional, Arnold, J.C., additional, Asmaro, D., additional, Auwärter, V., additional, Bachmann, S., additional, Baker, A., additional, Balter, R.E., additional, Baraldi, P.G., additional, Barber, P.A., additional, Barbería, E., additional, Bar-Sela, G., additional, Bastiani, L., additional, Basu, D., additional, Basurte, I., additional, Beck, O., additional, Behrendt, S., additional, Bergen-Cico, D., additional, Berrendero, F., additional, Bhagav, P., additional, Bhattacharyya, S., additional, Bioque, M., additional, Bolkent, S., additional, Boman, J.H., additional, Bondallaz, P., additional, Bonnet, U., additional, Borges, R.S., additional, Borowiak, K., additional, Boschi, I., additional, Brents, L.K., additional, Bridts, C.H., additional, Bruno, A., additional, Burrows, B.T., additional, Busatto, G.F., additional, Callaghan, R.C., additional, Campos, A.C., additional, Camsari, U.M., additional, Canfield, A., additional, Carra, E., additional, Carrillo-Salinas, F.-J., additional, Cascini, F., additional, Castelli, M.P., additional, Cawich, S.O., additional, Cawston, E.E., additional, Cedro, C., additional, Chagas, M.H.N., additional, Chen, C., additional, Chisari, C., additional, Chtioui, H., additional, Cico, R.D., additional, Ciechomska, I.A., additional, Coimbra, N.C., additional, Cole, J., additional, Cookey, J., additional, Copeland, J., additional, Coskun, Z.M., additional, Crano, W.D., additional, Crippa, J.A.S., additional, Crocker, C.E., additional, Cuesta, M.J., additional, Cunha, P.J., additional, Cutando, L., additional, da Silva, A.B.F., additional, da Silva, J.A., additional, da Silva, V.K., additional, Dan, D., additional, De Boni, R.B., additional, Rodríguez de Fonseca, F., additional, Gómez de Heras, R., additional, de Oliveira, A.C.P., additional, de Souza Crippa, A.C., additional, de Souza Crippa, J.A., additional, Degenhardt, F., additional, Degenhardt, L., additional, Deiana, S., additional, Deonarine, U., additional, Di Forti, M., additional, dos Anjos-Garcia, T., additional, Guimarães dos Santos, R., additional, Drozd, M., additional, Duran, F.L.S., additional, Earleywine, M., additional, Ebo, D.G., additional, Egashira, N., additional, Egnatios, J., additional, Ellert-Miklaszewska, A., additional, ElShebiney, S.A., additional, ElSohly, M.A., additional, Evren, C., additional, Fañanás, L., additional, Faber, M.M., additional, Farag, S., additional, Farré, A., additional, Farré, M., additional, Fatjó-Vilas, M., additional, Favrat, B., additional, Feingold, D., additional, Feliú, A., additional, Fernández, A.A., additional, Fernández-Artamendi, S., additional, Ferrari, A.J., additional, Ferraro, L., additional, Fichna, J., additional, Finlay, D.B., additional, Fiz, J., additional, Flores, Á., additional, Fogel, J.S., additional, Fornari, E., additional, Fortunato, L., additional, Fyfe, T., additional, Gaafar, A.E.D.M., additional, Gade, S., additional, Gaffal, E., additional, Galal, A.F., additional, Gandhi, R., additional, Gates, P., additional, Gatley, J.M., additional, Giroud, C., additional, Glass, M., additional, Goldberg, S.R., additional, González-Ortega, I., additional, González-Pinto, A., additional, Guaza, C., additional, Guillon, V., additional, Guimarães, F.S., additional, Gul, W., additional, Guven, F.M., additional, Hall, W.D., additional, Hallak, J.E.C., additional, Hamerle, M., additional, Haney, M., additional, Harding, H.E., additional, Hassan, S., additional, Haugland, K., additional, Healey, A., additional, Heck, C., additional, Helander, A., additional, Hernandez-Folgado, L., additional, Herzig, D.A., additional, Hesse, M., additional, Hill, M.G., additional, Hirst, R., additional, Hjorthøj, C.R., additional, Hoch, E., additional, Holder, M.D., additional, Holtkamp, M., additional, Hunter, M.R., additional, Ikeda, E., additional, Izumi, Y., additional, Janus, T., additional, Kaminska, B., additional, Kanaan, A.S., additional, Karinen, R., additional, Karl, T., additional, Katsu, T., additional, Kay-Lambkin, F., additional, Kayser, O., additional, Kells, M., additional, Kelly, B.C., additional, Kelly, T.H., additional, Kokona, A., additional, Kumar, A., additional, Kumar, P., additional, La Barbera, D., additional, Lagerberg, T.V., additional, Lahat, A., additional, Larsen, H.J., additional, Laun, A.S., additional, Lecomte, T., additional, Legleye, S., additional, Lev-Ran, S., additional, Lile, J.A., additional, Limberger, R.P., additional, Linares, I.M.P., additional, Lisdahl, K.M., additional, Little, M., additional, Liu, W., additional, Loflin, M.J., additional, Lorente-Omeñaca, R., additional, Lorenzetti, V., additional, Lu, D., additional, Mørland, J., additional, Müller-Vahl, K.R., additional, Machoy-Mokrzyńska, A., additional, Maeder, P., additional, Majumdar, S., additional, Maldonado, R., additional, Maple, K.E., additional, Marrón, T., additional, Martínez-Cengotitabengoa, M., additional, Martín-Fontelles, M. Isabel, additional, Martín-Santos, R., additional, Masuda, K., additional, McRae-Clark, A.L., additional, Mecha, M., additional, Medallo, J., additional, Melle, I., additional, Menahem, S., additional, Mendes-Gomes, J., additional, Mesías, B., additional, Miller, S., additional, Mizrahi, R., additional, Molinaro, S., additional, Moore, C., additional, Moraes, M.F., additional, Moreira, F.A., additional, Moreno-Izco, L., additional, Morris, H.A., additional, Muñoz, E., additional, Muccioli, G.G., additional, Muscatello, M.R.A., additional, Nada, S.A., additional, Naraynsingh, V., additional, Narimatsu, S., additional, Nogueira-Filho, G., additional, Nordentoft, M., additional, Oguz, G., additional, Øiestad, Å.M.L., additional, Øiestad, E.L., additional, Okazaki, H., additional, Olive, M.F., additional, Orio, L., additional, Ozaita, A., additional, Pérez, A., additional, Panagis, G., additional, Pandolfo, G., additional, Panlilio, L.V., additional, Paquin, K., additional, Parakh, P., additional, Parker, L.A., additional, Patel, V.B., additional, Pawson, M., additional, Peres, F.F., additional, Petras, H., additional, Pollastro, F., additional, Porcu, A., additional, Potente, R., additional, Potter, D.E., additional, Potvin, S., additional, Prats, C., additional, Preedy, V.R., additional, Rajendram, R., additional, Rathke, L., additional, Reed, K.L., additional, Repka, M.A., additional, Rigter, H., additional, Rock, E.M., additional, Rohrbacher, H., additional, Rosa, P.G.P., additional, Sánchez-Martínez, F., additional, Sánchez-Torres, A.M., additional, Sałaga, M., additional, Sabato, V., additional, Sanders, A.N., additional, Santos, L.C., additional, Scalese, M., additional, Schaufelberger, M.S., additional, Schröder, N., additional, Scimeca, G., additional, Secades-Villa, R., additional, Selvarajah, D., additional, Senormanci, O., additional, Shivakumar, K., additional, Shrier, L.A., additional, Siciliano, V., additional, Sideli, L., additional, Siegel, J.T., additional, Sleem, A.A., additional, Sobczyński, J., additional, Sodos, L., additional, Solowij, N., additional, Song, Z.-H., additional, Stacy, A.W., additional, Stehle, F., additional, Stogner, J.M., additional, Sussman, S., additional, Swift, W., additional, Szerman, N., additional, Tüting, T., additional, Aghazadeh Tabrizi, M., additional, Taglialatela-Scafati, O., additional, Takahashi, R.N., additional, Takeda, S., additional, Tarricone, I., additional, Tashkin, D.P., additional, Tellioğlu, T., additional, Tellioğlu, Z., additional, Tesfaye, S., additional, Thornton, L., additional, Thylstrup, B., additional, Tibbo, P.G., additional, Todd, G., additional, Torrens, M., additional, Tsai, J., additional, Tseng, H.-H., additional, Turner, A., additional, Tuv, S.S., additional, Ullah, F., additional, Van der Linden, T., additional, Van Gasse, A.L., additional, Vega, P., additional, Vera, G., additional, Verdichevski, M., additional, Vieira Sousa, T.R., additional, Vilela, L.R., additional, Vindenes, V., additional, Walsh, Z., additional, Watanabe, K., additional, Watterson, L.R., additional, White, J.M., additional, Wright, N.E., additional, Yücel, M., additional, Yamamoto, I., additional, Yamaori, S., additional, Zalesky, A., additional, Zalman, D., additional, Zhang, J., additional, Zhang, Y., additional, Zoccali, R., additional, Zorumski, C.F., additional, and Zuardi, A.W., additional

Published
2017
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14. Abstracts

Author

Kaatsch, Hans-Jürgen, Püschel, K., Heinemann, A., Klaas, Jakob, Graß, Hildegard, Staak, Michael, Benthaus, S., Vock, R., Brinkmann, B., Temme, O., Daldrup, T., Dilger, M., Fink, T., Rittner, Ch., Thali, Michael J., Braun, M., Brueschweiler, W., Kneubuehl, B. P., Vock, P., Wirth, J., Dirnhofer, R., Bohnert, M., Berger, H., Buck, U., Pollak, S., Gotta, J. C., Erdmann, F., Riße, M., Schütz, H., Weiler, G., Pragst, F., Auwärter, V., Sporkcrt, F., Roewer, L., Willuweit, S., Kayser, M., Nagy, M., de Knijff, P., Geserick, G., Augustin, C., Betz, A., Carracedo, A., Corach, D., Dupuy, B. M., Gusmaõ, L., Henke, L., Hidding, M., Kärgel, H. J., Lessig, R., Liebeherr, E., Parson, W., Pascali, V. L., Rolf, B., Schneider, P. M., Dobosz, T., Teifel-Greding, J., Krawczak, M., Bauer, M., Patzelt, D., Kuznik, J., Bondy, B., Eisenmenger, W., Möller, H. -J., Zehner, R., Niess, C., Amendt, J., Krettek, R., Weinmann, W., Görner, M., Goerke, R., Mahler, H., Fowinkel, C., Haarhoff, K., Schmidt, P., Schmolke, C., Mußhoff, F., Menzen, M., Prohaska, C., Madea, B., Kauert, G., Gleicher, S., Drasch, G., von Meyer, L., Roider, G., Quitterer, D., Kröner, L., Toennes, S. W., Jurowich, S., Käferstein, H., Sticht, G., Gilg, T., Priemer, F., Jocham, N., Fechner, G., Ortmann, Ch., Schulte, T., Nieschalk, M., Weirich, V., Rummel, J., Rentsch, D., Wegener, R., Berehaus, G., Graß, H., Grellner, W., Rettig-Stürmer, A., Kühn-Becker, H., Georg, T., Möller, M., Wilske, J., Kemmerling, R., Sachs, H., Menting, T., Musshoff, F., Schoenemeier, S., Bürrig, K. -F., Jacob, B., Bonte, W., Maeda, H., Zhu, B. -L., Fujita, M. Q., Quan, L., Ishida, K., Taniguchi, M., Böhme, B., Rauch, E., Penning, R., Amberg, R., Blackwell, C. C., Pelz, K., Meier, V., Saternus, K. -S., Gessler, F., Böhnel, H., Bouska, I., Toupalík, P., Klir, P., Kleemann, W. J., Ast, F., Beck, U., Debertin, S., Giebe, B., Heide, S., Sperhake, J., Poets, C. F., Weis, C., Schlaud, M., Bajanowski, T., Wedekind, H., Breithardt, G., Debertin, A. S., Tönjes, H., Tschernig, T., Pabst, R., Tröger, H. D., Krill, A., Hame, M., Bouška, I., Ježková, J., Kernbach-Wighton, G., Wense, A. v. d., Kijewski, H., Goeke, M., Weber, B., Staak, M., Dettmeyer, R., Driever, F., Becker, A., Wiestler, O. D., Verhoff, M. A., Woenckhaus, J., Hauri-Bionda, R., Strehler, M., Bär, W., Ohshima, T., Takayasu, T., Kondo, T., Sato, Y., Tarbah, Fuad A., Mahler, Hellmut, Temme, Oliver, Daldrup, Thomas, Pötsch, Lucia, Emmerich, Patricia, Skopp, Gisela, Andresen, H., Schmoldt, A., Thurau, K., Vogt, S., Große-Perdekamp, M., Pufal, E., Sykutera, M., Rochholz, G., Lis, G., Sliwka, K., Zörntlein, S., Röhrich, J., Pötsch, L., Becker, J., Mattern, Rainer, Yamamoto, Yoshiko, Hayase, Tamaki, Yamamoto, Keiichi, Piette, Michel H. A., De Letter, Els A., Cordonnier, Jan, Schultes, A., Pluisch, F., Darok, M., Kollroser, M., Mannweiler, S., Babel, B., Magerl, H., Mahfoud, B., Stein, S., Iwersen-Bergmann, S., Risser, D., Hönigschnabl, S., Stichenwirth, M., Sebald, D., Kaff, A., Schneider, B., Vycudilik, W., Bauer, G., Reitz, E., Kimont, H. -G., Molnár, A., Jeszenszky, E., Benkó, A., Száz, E., Varga, T., Mayr, N. P., Schmidbauer, S., Hallfeldt, K., Bank, A., Iffland, R., Schuff, A., Fischer, T., Weingarten, Y., Alt, A., Janda, I., Wurst, F. M., Seidl, S., Seitler, C., Haag-Dawoud, Munira, Beike, J., Vennemann, B., Köhler, H., Hendreich, F. -I., Giebe, W., Reimann, I., Werner, R., Klein, A., Schulz, K., Feischer, D., Erfurt, Ch., Arnold, R., Winnefeld, K., Riepert, T., Iffland, R., Longauer, F., Kardošovå, V., Anders, S., Hildebrand, E., Schulz, F., Möbus, U., Jaroß, W., Wittig, H., Schmidt, U., Hauptmann, K., Krause, D., Prudlow, B., Rohner, T., Molz, G., Früchtnicht, W., Hoppe, B., Henßge, C., Althaus, L., Herbst, J., Preiß, U., Stein, C., Glenewinkel, F., Leinzinger, E. P., Lászik, A., Soós, M., Hubay, M., Sótonyi, P., Schliff, A., Gatternig, R., Hering, S., Edelmann, J., Plate, I., Michael, M., Kuhlisch, E., Szibor, R., von Wurmb, N., Hammer, U., Meissner, D., Kirches, E., Dietzmann, K., Pfeiffer, H., Ortmann, C., Meißner, C., Mohamed, S. A., Warnk, H., Gehlsen-Lorenzen, A., Oehmichen, M., Heidorn, F., Henkel, R., Schulz, M. M., Reichert, W., Mattern, R., Baasner, A., Banaschak, S., Schäfer, C., Benecke, M., Reibe, S., Barksdale, Larry, Sundermeier, Jon, Ratcliffe, Brett C., Lutz, S., Hohoff, C., Schürenkamp, M., Kahle, C., Fieguth, A., Ritz-Timme, S., Laumeier, I., Schütz, H. W., Schulte-Mönting, J., Chaudri, S., Welti, M., Dittmann, V., Olze, A., Schmeling, A., Reisinger, W., Klotzbach, H., Gabriel, P., Demir, T., Huckenbeck, W., Reuhl, J., Schuster, R., Maxeiner, H., Bockholdt, B., Jachau, K., Kuchheuser, W., Försterling, T., Ehrlich, E., Besselmann, M., Du Chesne, A., Albrecht, U. -V., Guan, D. W., Dreßler, J., Voigtmann, K., Müller, E., Vieler, S., Kirchner, A., Humpert, M., Breitmeier, D., Mansouri, F., Wyler, D., Marty, W., Sigrist, Th., Zollinger, U., Meyer, U., Allmen, G. v., Karger, B., Hoekstra, A., Stehmann, B., Schmidt, P. F., Peschel, O., Vollmar, C., Szeimies, U., Rothschild, M. A., Kegel, D., Klatt, A., Klatt, C., Briese, B. -H., Schyma, C., Schyma, P., Angetter, Daniela, Perdekamp, M. Große, Sun, Y., Guttenberge, R., Riede, U. -N., Poetsch, M., Seefeldt, S., Maschke, M., Lignitz, E., Zeller, M., Wehner, H. -D., Czarnetzki, A., Blin, N., Bender, K., Emmerich, P., Pádár, Zs., Egyed, B., Kemény, G., Woller, J., Füredi, S., Balogh, I., Cremer, U., Scheil, H. -G., Schiwy-Bochat, K. -H., Althoff, H., Immel, U. -D., Tatschner, Th., Lang, C., Versmold, D., Reineke, Th., Mall, G., Dahlmann, F., Büttner, A., Hubig, M., Rötzscher, K., Grundmann, C., Oritani, S., Peter, J., Popov, V., Olejnik, V., Khokhlov, V. D., Stiller, D., Romanowski, U., Kleiber, M., Klupp, N., Mortinger, H., Chadová, L., Bouška, I., Toupalik, P., Schnabel, A., Lutz, F. -U., Crivellaro, A., Strauch, H., Dan, Dermengiu, Silvia, Dermengiu, Buda, Octavian, Kandolf, R., Kaiser, R., Eis-Hübinger, A. M., Kobek, M., Jankowski, Z., Rygol, K., Kulikowska, J., Martin, H., Kolbow, K., Keil, W., Wang, Huijun, Ding, Yanqing, Huang, Guangzhao, Wu, Zhongbi, Wehner, F., Subke, J., Zdravkovic, M., Otasevic, V., Rostov, M., Karadzic, R., Kildüschov, E. M., Buromski, I. W., Plaksin, W. O., Wendland, A., Spiridonow, W. A., Sabusow, J. G., Kalinin, J. P., Heide, S., Schmidt, V., Wiegand, P., Kleiber, M., Demmler, G., Zack, F., Reischle, S., Schönpflug, M., Beier, G., Berchtenbreiter, C., Lackner, K., Jendrusch, B., Wolf, H., Buhmann, D., Summa, H., Matschke, J., Stürenburg, H. J., Junge, M., Wischhusen, F., Müldner, C., Schröder, A., Kaiser, E., Lasczkowski, G., Hofbauer, V., Eberl, N., Thomson, H., Tatschner, T., Milz, S., Gazov, E., Trübner, K., Brenner, M., Tsokos, M., Anders, S., Paulsen, F., Reith, K., Bratzke, H., Schapfeld, R., Graefe-Kirci, U., Stiller, D., Trübner, K., and Schäfer, A. Th.

Published
2000
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19. Das Neue-psychoaktive-Stoffe-Gesetz

Author

Kraus, LN, additional, Kühnl, RM, additional, Aydin, D, additional, Schiemann, A, additional, Verthein, U, additional, Mühlig, S, additional, Koller, G, additional, Auwärter, V, additional, Hermanns-Clausen, M, additional, and Patzak, J, additional

Published
2019
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28. Akute Vergiftungen durch neue psychoaktive Drogen im Kindesalter: EU Project 'SPICE II Plus'

Author

Kithinji, J., Auwärter, V., Szabo, B., and Hermanns-Clausen, M.

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Fragestellung: Seit 2008 wurden zahlreiche neue psychoaktive Substanzen (NPS), darunter mehr als 40 verschiedene synthetische Cannabinoide (SC), als Partydrogen vor allem über das Internet vertrieben. Ziel dieser Untersuchung ist es die NPS zu identifizieren, die aufgrund unerwünschter Wirkungen[for full text, please go to the a.m. URL], Süddeutscher Kongress für Kinder- und Jugendmedizin; 63. Jahrestagung der Süddeutschen Gesellschaft für Kinder- und Jugendmedizin gemeinsam mit der Süddeutschen Gesellschaft für Kinderchirurgie und dem Berufsverband der Kinder- und Jugendärzte e.V. – Landesverband Baden-Württemberg

Published
2014
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39. Letale Doxepinintoxikation

Author

Neukamm, M., primary, Vogt, S., additional, Hermanns-Clausen, M., additional, Naue, J., additional, Thierauf, A., additional, and Auwärter, V., additional

Published
2012
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41. Alkoholkonsummarker

Author

Thierauf, A., primary, Große Perdekamp, M., additional, Weinmann, W., additional, and Auwärter, V., additional

Published
2010
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48. Wipe-test and patch-test for alcohol misuse based on the concentration ratio of fatty acid ethyl esters and squalene CFAEE/CSQ in skin surface lipids

Author

Pragst, F., Auwärter, V., Kießling, B., and Dyes, C.

Subjects
*FATTY acids, *SKIN tests, *PROTEINS, *ALCOHOL drinking
Abstract

Fatty acid ethyl esters (FAEE) are known to be formed in blood and almost all human tissues after alcohol consumption and to be incorporated from sebum into hair where they can be used as long-term markers for excessive alcohol consumption. In order to examine whether skin surface lipids which consist mainly of sebum are an equally useful matrix for measurement of FAEE as alcohol abuse markers, samples were collected by a wipe-test from the forehead of 13 teetotallers, 16 social drinkers, 10 death cases with known recent alcohol misuse and five death cases without indications of alcohol misuse. The samples were analysed by headspace solid-phase microextraction and gas chromatography–mass spectrometry for ethyl myristate, ethyl palmitate, ethyl oleate and ethyl stearate and by high performance liquid chromatography with photodiode array detector for squalene, (SQ), as a natural reference substance which the FAEE concentrations were related to. The ratio mFAEE/mSQ ranged between 0.16 and 1.12 ng/μg (mean 0.34 ng/μg) for the teetotallers and between 0.08 and 0.94 ng/μg (mean 0.37 ng/μg) for the social drinkers with no significant difference between both groups. For the alcoholics 2.4–24.2 ng/μg (mean 13.1 ng/μg) were found. For two volunteers the course of mFAEE/mSQ 2 weeks before and 3 weeks after a single high alcohol dose was pursued by daily wipe tests. A strong increase of mFAEE/mSQ occurred between 7 and 12 days after the drinking event. This delay can be explained by the transition time of about 8 days between sebum production and its appearance on the skin surface known from literature. For seven social drinkers skin surface lipid samples were also collected using drug of abuse patches of the firm PharmCheck. The ratios mFAEE/mSQ in these samples were in the same range as from the wipe-test. The comparison with the self-reported ethanol amounts consumed the week before and during the test gave no good correlation (R2 = 0.42). It can be concluded from the results that FAEE in skin surface lipids can be used for medium-term retrospective detection of heavy drinking. [Copyright &y& Elsevier]

Published
2004
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49. Metabolism of synthetic cannabinoid receptor agonists encountered in clinical casework: major in vivo phase I metabolites of JWH-007, JWH-019, JWH-203, JWH-307, UR-144, XLR-11, AM-2201, MAM-2201 and AM-694 in human urine using LC-MS/MS

Author

Hutter, M, Broecker, S, Kneisel, S, Franz, F, Brandt, SD, and Auwärter, V

Subjects
RM, QD
Abstract

Background: `Herbal mixtures` containing synthetic cannabinoid receptor agonists (SCRAs) are promoted as legal alternative to marihuana and are easily available via the Internet. Keeping analytical methods for the detection of these SCRAs up-to-date is a continuous challenge for clinicians and toxicologists due to the high diversity of the chemical structures and the frequent emergence of new compounds. Since many SCRAs are extensively metabolized, analytical methods used for urine testing require previous identification of the major metabolites of each compound. Objective: The aim of this study was to identify the in vivo major metabolites of nine SCRAs (AM-694, AM-2201, JWH-007, JWH-019, JWH-203, JWH-307, MAM-2201, UR-144, XLR-11) for unambiguous detection of a drug uptake by analysis of urine samples. Method: Positive urine samples from patients of hospitals, detoxification and therapy centers as well as forensic-psychiatric clinics were analyzed by means of liquid chromatography-tandem mass spectrometry (LC-MS/MS) and liquid chromatography-quadrupol time-of-flight mass spectrometry (LC-qToF-MS) for investigation of the in vivo major metabolites. Results: For all investigated SCRAs, monohydroxylation, dihydroxylation and/or formation of the N-pentanoic acid metabolites were among the most abundant metabolites detected in human urine samples. Substitution of the fluorine atom was observed to be an important metabolic reaction for compounds carrying an N-(5-fluoropentyl) chain. Dealkylated metabolites were not detected in vivo. Conclusion: The investigated metabolites facilitate the reliable detection of drug uptake by analysis of urine samples. For distinction between uptake of the fluorinated and the non-fluorinated analogs, the N-(4-hydroxypentyl) metabolite of the non-fluorinated analog was identified as a useful analytical target and consumption marker.

50. Accidental clozapine intoxication in a toddler: clinical and pharmacokinetic lessons learnt.

Author

Toepfner, N., Wohlfarth, A., Naue, J., Auwärter, V., Berner, R., and Hermanns‐Clausen, M.

Subjects
CLOZAPINE, COMA, RESPIRATORY insufficiency, RESPIRATORY aspiration, DISEASE complications, CHILDREN
Abstract

What is known and Objective: Clozapine, a second generation antipsychotic which is relatively safe in overdose, has been used as an effective treatment alternative to traditional antipsychotics. The therapeutic use in children remains controversial. However, in accordance with the increasing prescription in adults, the accidental ingestion in childhood becomes more frequent. We report the youngest case of accidental clozapine ingestion. Case summary: A 13-month-old girl presented with acute respiratory insufficiency and coma of unknown origin. The medical history, laboratory and radiological assessment did not link to aetiology until an almost spontaneous arousal after 22 h pointed towards intoxication. The initial standard drug screening using immunoassay had been negative. Hence, liquid chromatography mass spectrometry/mass spectrometry (LC-MS/MS) was performed, and clozapine was detected with a serum concentration of 736 ng/mL. What is new and Conclusion: This case illustrates the diagnostic and forensic pitfalls in a coma of unknown origin due to the limits of toxicological screening immunoassays. LC-MS/MS analysis by an established method showed clozapine metabolites (norclozapine and clozapine-N-oxide) are detectable for longer period, especially in urine, when compared with clozapine. The clinical course is presented in unique correlation with plasma and urine concentrations of clozapine and its metabolites. The elimination pattern of clozapine in toddlers is similar to adults, and the toxic dose was found to be lower when compared with school-age children and adults. [ABSTRACT FROM AUTHOR]

Published
2013
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