经分析证实的4-甲基哌醋甲酯中毒，哌醋甲酯类似物。,Journal of Analytical Toxicology

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经分析证实的4-甲基哌醋甲酯中毒，哌醋甲酯类似物。
Journal of Analytical Toxicology ( IF 2.3 ) Pub Date : 2019-06-01 , DOI: 10.1093/jat/bkz001
Pietro Papa ₁ , Antonella Valli ₁ , Marcello Di Tuccio ₁ , Giampietro Frison ₂ , Flavio Zancanaro ₂ , Eleonora Buscaglia ₃ , Carlo Alessandro Locatelli ₃

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4-氟甲基哌啶盐（4F-MPH）是哌醋甲酯（MPH）的卤代衍生物，是多巴胺和去甲肾上腺素的再摄取抑制剂，用于治疗注意力不足过动症。在最近几年中，几种与MPH结构相关的化合物已被标记为新的精神活性物质（NPS），具有与母体药物相似的刺激和欣快作用，但具有更多的多巴胺能活性。该报告代表了4F-MPH经分析证实的非致命性中毒的第一例。一名26岁的女性因神经精神和心脏病症状进入急诊室，持续了一个星期，在此期间，她在互联网上嗅到一种以4T-MPH为触媒原的粉末。该患者需要静脉注射地西epa镇静，两天后服用普嗪和喹硫平处方出院。通过气相色谱-质谱，液相色谱-高分辨率质谱和核磁共振对被检产物进行分析表征。这些分析证实了产物的组成为4F-MPH非对映异构体（±）-苏式和（±）-赤型混合物，具有大量的活性（±）-苏式异构体。通过液相色谱-串联质谱法对生物样品中4F-MPH的定量进行了最小限度的验证，旨在用于稀有分析物。血液和尿液的准确度（偏差）和精确度均在±15％以内。（±）-苏式4F-MPH的血液和尿液浓度分别为32 ng / mL和827 ng / mL。对经典药物（鸦片，美沙酮，可卡因，大麻代谢产物，苯丙胺，摇头丸和LSD），乙醇，气相色谱-质谱定性全屏分析和液相色谱-串联质谱法对50 NPS进行目标分析，结果均为阴性; 合并症也被排除在外。根据这些数据，可以假定临床表现仅归因于4F-MPH。

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Analytically Confirmed Intoxication by 4-Fluoromethylphenidate, an Analog of Methylphenidate.

4-Fluoromethylphenidate (4F-MPH) is an halogenated derivative of methylphenidate (MPH), a re-uptake inhibitor for dopamine and norepinephrine used for the treatment of attention deficit hyperactivity disorders. In the last few years, several compounds structurally related to MPH have been marked as new psychoactive substances (NPS) with stimulating and euphoric effects similar to the parent drug, but with more dopaminergic activity. This report represents the first case of an analytically confirmed non-fatal intoxication by 4F-MPH. A 26-year-old female was admitted to the emergency department with neuropsychiatric and cardiologic symptoms that lasted for a week, during which she sniffed a powder named 4F-MPH acquired as entactogen on the Internet. The patient required sedation with intravenous diazepam and was discharged two days later with a prescription of promazine and quetiapine. The seized product was analytically characterized by gas chromatography-mass spectrometry, liquid chromatography high-resolution mass spectrometry and nuclear magnetic resonance. These analyses confirmed the composition of the product as a 4F-MPH diastereomeric (±)-threo and (±)-erythro mixture, with a large preponderance of the active (±)-threo isomer. A minimal validation, intended for rare analytes, was performed for the quantification of 4F-MPH in the biological samples by liquid chromatography-tandem mass spectrometry. Accuracy (bias) and precision were within ±15% for both blood and urine. The blood and urine concentration of (±)-threo 4F-MPH were 32 ng/mL and 827 ng/mL, respectively. Analyses for classic drugs (opiates, methadone, cocaine, cannabis metabolites, amphetamines, ecstasy and LSD), ethanol, qualitative full screen by gas chromatography-mass spectrometry and targeted analysis for 50 NPS by liquid chromatography-tandem mass spectrometry tested negative; comorbidities were excluded, too. Based on these data, it can be assumed that the clinical manifestations were due to 4F-MPH only.

更新日期：2019-11-01

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