A fatal poisoning involving 25C-NBOMe

Highlights • A fatal overdose case involving the potent hallucinogenic drug 25C-NBOMe. • Clinical symptoms during intoxication and toxicological evaluation. • Quantification of 25C-NBOMe in biological specimens from the deceased using UPLC–MS/MS. • Identification of a demethylated and glucuronidated...

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Published in	Forensic science international Vol. 251; pp. e1 - e8
Main Authors	Andreasen, Mette Findal, Telving, Rasmus, Rosendal, Ingrid, Eg, Marlene Beyer, Hasselstrøm, Jørgen Bo, Andersen, Ljubica Vukelic
Format	Journal Article
Language	English
Published	Ireland Elsevier Ireland Ltd 01.06.2015 Elsevier Limited
Subjects	25C-NBOMe Amphetamines Autopsies Benzylamines - analysis Benzylamines - poisoning Blood Blood pressure Cardiac arrhythmia Chromatography, Liquid Coma Drug Overdose Drugs Fatal Fatalities Forensic sciences Forensic Toxicology Gastrointestinal Contents - chemistry Glucose Hallucinogens - analysis Hallucinogens - poisoning Humans Ingestion Inhalant Abuse Internet Intoxication LC–MS/MS Liquid chromatography Male Mass Spectrometry Metabolism Metabolites Multiple organ failure Pathology Phenethylamines - analysis Phenethylamines - poisoning Serotonin UPLC–TOFMS Urine Vitreous Body - chemistry Young Adult Multiple organ failure Intoxication UPLC–TOFMS LC–MS/MS 25C-NBOMe
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Abstract	Highlights • A fatal overdose case involving the potent hallucinogenic drug 25C-NBOMe. • Clinical symptoms during intoxication and toxicological evaluation. • Quantification of 25C-NBOMe in biological specimens from the deceased using UPLC–MS/MS. • Identification of a demethylated and glucuronidated metabolite using HR-TOFMS.
AbstractList	This paper reports on a fatal overdose case involving the potent hallucinogenic drug 25C-NBOMe (2-(4-chloro-2,5-dimethoxyphenyl)-N-[(2-methoxyphenyl)methyl]ethan a mine). In the present case, a young male was hospitalized after the recreational use of this potent drug. He died at the hospital at approximately 12h after ingestion, with preceding signs of serotonin toxicity. Medico-legal autopsy was performed on the deceased, during which time peripheral whole blood, urine, vitreous humor, liver and gastric content samples were submitted for toxicological examination. Further, whole blood collected at the hospital at 2-4h following ingestion of the drug was analyzed. 25C-NBOMe and a demethylated and glucuronidated metabolite of 25C-NBOMe were identified in the urine and blood samples using ultra-performance liquid chromatography with high-resolution time-of-flight mass spectrometry (UPLC-HRTOF-MS). Subsequently, 25C-NBOMe was quantified in the peripheral whole blood (0.60 mu g/kg), urine (2.93 mu g/kg), vitreous humor (0.33 mu g/kg), liver (0.82 mu g/kg) and gastric content (0.32 mu g total) samples collected during autopsy and in the ante-mortem whole blood (0.81 mu g/kg) by ultra-performance liquid chromatography with tandem mass spectrometry (UPLC-MS/MS). The autopsy findings were consistent with acute poisoning. Based on the toxicological findings, the cause of death was determined to be a fatal overdose of 25C-NBOMe in combination with amphetamine intake. To our knowledge, the present paper reports the first quantification of 25C-NBOMe in biological specimens from a fatal intoxication case. This paper reports on a fatal overdose case involving the potent hallucinogenic drug 25C-NBOMe (2-(4-chloro-2,5-dimethoxyphenyl)-N-[(2-methoxyphenyl)methyl]ethanamine). In the present case, a young male was hospitalized after the recreational use of this potent drug. He died at the hospital at approximately 12h after ingestion, with preceding signs of serotonin toxicity. Medico-legal autopsy was performed on the deceased, during which time peripheral whole blood, urine, vitreous humor, liver and gastric content samples were submitted for toxicological examination. Further, whole blood collected at the hospital at 2-4h following ingestion of the drug was analyzed. 25C-NBOMe and a demethylated and glucuronidated metabolite of 25C-NBOMe were identified in the urine and blood samples using ultra-performance liquid chromatography with high-resolution time-of-flight mass spectrometry (UPLC-HRTOF-MS). Subsequently, 25C-NBOMe was quantified in the peripheral whole blood (0.60[micro]g/kg), urine (2.93[micro]g/kg), vitreous humor (0.33[micro]g/kg), liver (0.82[micro]g/kg) and gastric content (0.32[micro]g total) samples collected during autopsy and in the ante-mortem whole blood (0.81[micro]g/kg) by ultra-performance liquid chromatography with tandem mass spectrometry (UPLC-MS/MS). The autopsy findings were consistent with acute poisoning. Based on the toxicological findings, the cause of death was determined to be a fatal overdose of 25C-NBOMe in combination with amphetamine intake. To our knowledge, the present paper reports the first quantification of 25C-NBOMe in biological specimens from a fatal intoxication case. Highlights • A fatal overdose case involving the potent hallucinogenic drug 25C-NBOMe. • Clinical symptoms during intoxication and toxicological evaluation. • Quantification of 25C-NBOMe in biological specimens from the deceased using UPLC–MS/MS. • Identification of a demethylated and glucuronidated metabolite using HR-TOFMS. •A fatal overdose case involving the potent hallucinogenic drug 25C-NBOMe.•Clinical symptoms during intoxication and toxicological evaluation.•Quantification of 25C-NBOMe in biological specimens from the deceased using UPLC–MS/MS.•Identification of a demethylated and glucuronidated metabolite using HR-TOFMS. This paper reports on a fatal overdose case involving the potent hallucinogenic drug 25C-NBOMe (2-(4-chloro-2,5-dimethoxyphenyl)-N-[(2-methoxyphenyl)methyl]ethanamine). In the present case, a young male was hospitalized after the recreational use of this potent drug. He died at the hospital at approximately 12h after ingestion, with preceding signs of serotonin toxicity. Medico-legal autopsy was performed on the deceased, during which time peripheral whole blood, urine, vitreous humor, liver and gastric content samples were submitted for toxicological examination. Further, whole blood collected at the hospital at 2–4h following ingestion of the drug was analyzed. 25C-NBOMe and a demethylated and glucuronidated metabolite of 25C-NBOMe were identified in the urine and blood samples using ultra-performance liquid chromatography with high-resolution time-of-flight mass spectrometry (UPLC–HRTOF–MS). Subsequently, 25C-NBOMe was quantified in the peripheral whole blood (0.60μg/kg), urine (2.93μg/kg), vitreous humor (0.33μg/kg), liver (0.82μg/kg) and gastric content (0.32μg total) samples collected during autopsy and in the ante-mortem whole blood (0.81μg/kg) by ultra-performance liquid chromatography with tandem mass spectrometry (UPLC–MS/MS). The autopsy findings were consistent with acute poisoning. Based on the toxicological findings, the cause of death was determined to be a fatal overdose of 25C-NBOMe in combination with amphetamine intake. To our knowledge, the present paper reports the first quantification of 25C-NBOMe in biological specimens from a fatal intoxication case. This paper reports on a fatal overdose case involving the potent hallucinogenic drug 25C-NBOMe (2-(4-chloro-2,5-dimethoxyphenyl)-N-[(2-methoxyphenyl)methyl]ethanamine). In the present case, a young male was hospitalized after the recreational use of this potent drug. He died at the hospital at approximately 12h after ingestion, with preceding signs of serotonin toxicity. Medico-legal autopsy was performed on the deceased, during which time peripheral whole blood, urine, vitreous humor, liver and gastric content samples were submitted for toxicological examination. Further, whole blood collected at the hospital at 2-4h following ingestion of the drug was analyzed. 25C-NBOMe and a demethylated and glucuronidated metabolite of 25C-NBOMe were identified in the urine and blood samples using ultra-performance liquid chromatography with high-resolution time-of-flight mass spectrometry (UPLC-HRTOF-MS). Subsequently, 25C-NBOMe was quantified in the peripheral whole blood (0.60μg/kg), urine (2.93μg/kg), vitreous humor (0.33μg/kg), liver (0.82μg/kg) and gastric content (0.32μg total) samples collected during autopsy and in the ante-mortem whole blood (0.81μg/kg) by ultra-performance liquid chromatography with tandem mass spectrometry (UPLC-MS/MS). The autopsy findings were consistent with acute poisoning. Based on the toxicological findings, the cause of death was determined to be a fatal overdose of 25C-NBOMe in combination with amphetamine intake. To our knowledge, the present paper reports the first quantification of 25C-NBOMe in biological specimens from a fatal intoxication case.
Author	Andreasen, Mette Findal Telving, Rasmus Andersen, Ljubica Vukelic Eg, Marlene Beyer Hasselstrøm, Jørgen Bo Rosendal, Ingrid
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Snippet	Highlights • A fatal overdose case involving the potent hallucinogenic drug 25C-NBOMe. • Clinical symptoms during intoxication and toxicological evaluation. •... •A fatal overdose case involving the potent hallucinogenic drug 25C-NBOMe.•Clinical symptoms during intoxication and toxicological evaluation.•Quantification... This paper reports on a fatal overdose case involving the potent hallucinogenic drug 25C-NBOMe...
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SubjectTerms	25C-NBOMe Amphetamines Autopsies Benzylamines - analysis Benzylamines - poisoning Blood Blood pressure Cardiac arrhythmia Chromatography, Liquid Coma Drug Overdose Drugs Fatal Fatalities Forensic sciences Forensic Toxicology Gastrointestinal Contents - chemistry Glucose Hallucinogens - analysis Hallucinogens - poisoning Humans Ingestion Inhalant Abuse Internet Intoxication LC–MS/MS Liquid chromatography Male Mass Spectrometry Metabolism Metabolites Multiple organ failure Pathology Phenethylamines - analysis Phenethylamines - poisoning Serotonin UPLC–TOFMS Urine Vitreous Body - chemistry Young Adult
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Title	A fatal poisoning involving 25C-NBOMe
URI	https://www.clinicalkey.es/playcontent/1-s2.0-S0379073815001164 https://dx.doi.org/10.1016/j.forsciint.2015.03.012 https://www.ncbi.nlm.nih.gov/pubmed/25841303 https://www.proquest.com/docview/1681957873/abstract/ https://search.proquest.com/docview/1732838285 https://search.proquest.com/docview/1770324398
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