1. Postmortem tissue distribution of MDPV following lethal intoxication by "bath salts".
- Author
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Wyman JF, Lavins ES, Engelhart D, Armstrong EJ, Snell KD, Boggs PD, Taylor SM, Norris RN, and Miller FP
- Subjects
- Adult, Alkaloids metabolism, Arrhythmias, Cardiac chemically induced, Autopsy, Benzodioxoles blood, Benzodioxoles cerebrospinal fluid, Brain metabolism, Cause of Death, Chromatography, High Pressure Liquid, Designer Drugs metabolism, Fatal Outcome, Forensic Toxicology methods, Gas Chromatography-Mass Spectrometry, Hair metabolism, Humans, Lung metabolism, Male, Muscle, Skeletal metabolism, Psychotropic Drugs blood, Psychotropic Drugs cerebrospinal fluid, Pyrrolidines blood, Pyrrolidines cerebrospinal fluid, Solid Phase Extraction, Substance Abuse Detection methods, Substance-Related Disorders complications, Substance-Related Disorders metabolism, Substance-Related Disorders pathology, Tandem Mass Spectrometry, Tissue Distribution, Synthetic Cathinone, Arrhythmias, Cardiac diagnosis, Baths, Benzodioxoles poisoning, Designer Drugs poisoning, Psychotropic Drugs poisoning, Pyrrolidines poisoning, Substance-Related Disorders diagnosis
- Abstract
3,4-Methylenedioxypyrovalerone (MDPV) is a psychoactive, synthetic analog of the central nervous system stimulant cathinone. Its recent popularity as a recreational drug in the United States has led to numerous reports to poison control centers across the country. As with other synthetic cathinones, the recreational use of MDPV has resulted in death. MDPV is thought to exert its pharmacologic effects by inhibiting the reuptake of dopamine and norepinephrine. This report describes the case of an exposure of a 39-year-old male to MDPV, which resulted in his death. Postmortem concentrations of MDPV in various tissues were measured. The detection of MDPV in tissues and fluids was accomplished using gas chromatography-mass spectrometry analysis after solid-phase extraction. Blood analysis also demonstrated therapeutic levels of lamotrigine, fluoxetine, risperidone, benztropine, pseudoephedrine and ibuprofen. The detection of cathinones in hair was conducted using high-performance liquid chromatography-tandem mass spectrometry after solid-phase extraction. MDPV was uniformly distributed among multiple tissues (blood, brain, muscle, cerebrospinal fluid and lung) at concentrations of approximately 0.4 to 0.6 µg/mL. Tissue and fluids responsible for detoxification/excretion had higher concentrations of MDPV (kidney, liver and bile > 0.8 µg/mL). A blood concentration ≥ 0.4 µg/mL was judged sufficient to cause death. The cause of death was ruled MDPV intoxication resulting in cardiac arrhythmia.
- Published
- 2013
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