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Acute 3,4-methylenedioxy-N-ethylcathinone (ethylone) intoxication and related fatality: a case report with postmortem concentrations.

Abstract

A 30-year-old man reportedly ingested pills and used illicit drugs with another person. They both fell asleep that night and the following afternoon the other person found him dead. There were used hypodermic needles and a metal spoon with dark tarry substance at the death scene, and two recent puncture sites were found on his body. It was uncertain if he had a history of illicit drug use. Postmortem blood initially screened borderline positive for methamphetamine by ELISA. An alkaline drug screen-detected ethylone which was subsequently confirmed and quantified by a specific GC-MS SIM analysis following solid-phase extraction. Concentrations were determined in the peripheral blood (0.39 mg/L), central blood (0.38 mg/L), liver (1.4 mg/kg), vitreous (0.58 mg/L), urine (20 mg/L) and gastric contents (12 mg). Other compounds detected in peripheral blood were morphine (0.05 mg/L), alprazolam (<0.05 mg/L), delta-9-THC (<1 ng/mL), delta-9-carboxy-THC (3.6 ng/mL) and naproxen (<5 mg/L). A urine screen (GC-MS) also confirmed 6-monoacetylmorphine, codeine and sildenafil. The cause of death was certified due to mixed ethylone, heroin and alprazolam intoxication. The manner of death was certified as accident.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    County of San Diego Medical Examiner's Office, 5570 Overland Avenue, Suite 101, San Diego, CA 92123, USA iain.mcintyre@sdcounty.ca.gov.

    ,

    County of San Diego Medical Examiner's Office, 5570 Overland Avenue, Suite 101, San Diego, CA 92123, USA.

    ,

    County of San Diego Medical Examiner's Office, 5570 Overland Avenue, Suite 101, San Diego, CA 92123, USA.

    ,

    County of San Diego Medical Examiner's Office, 5570 Overland Avenue, Suite 101, San Diego, CA 92123, USA.

    ,

    County of San Diego Medical Examiner's Office, 5570 Overland Avenue, Suite 101, San Diego, CA 92123, USA.

    County of San Diego Medical Examiner's Office, 5570 Overland Avenue, Suite 101, San Diego, CA 92123, USA.

    Source

    Journal of analytical toxicology 39:3 2015 Apr pg 225-8

    MeSH

    Accidents
    Acetone
    Adult
    Alprazolam
    Autopsy
    Cause of Death
    Drug Overdose
    Enzyme-Linked Immunosorbent Assay
    Ethylamines
    Fatal Outcome
    Forensic Toxicology
    Gas Chromatography-Mass Spectrometry
    Heroin
    Humans
    Male
    Predictive Value of Tests
    Solid Phase Extraction
    Street Drugs
    Substance Abuse Detection
    Substance-Related Disorders

    Pub Type(s)

    Case Reports
    Journal Article

    Language

    eng

    PubMed ID

    25540061

    Citation

    McIntyre, Iain M., et al. "Acute 3,4-methylenedioxy-N-ethylcathinone (ethylone) Intoxication and Related Fatality: a Case Report With Postmortem Concentrations." Journal of Analytical Toxicology, vol. 39, no. 3, 2015, pp. 225-8.
    McIntyre IM, Hamm CE, Sherrard JL, et al. Acute 3,4-methylenedioxy-N-ethylcathinone (ethylone) intoxication and related fatality: a case report with postmortem concentrations. J Anal Toxicol. 2015;39(3):225-8.
    McIntyre, I. M., Hamm, C. E., Sherrard, J. L., Gary, R. D., Burton, C. G., & Mena, O. (2015). Acute 3,4-methylenedioxy-N-ethylcathinone (ethylone) intoxication and related fatality: a case report with postmortem concentrations. Journal of Analytical Toxicology, 39(3), pp. 225-8. doi:10.1093/jat/bku146.
    McIntyre IM, et al. Acute 3,4-methylenedioxy-N-ethylcathinone (ethylone) Intoxication and Related Fatality: a Case Report With Postmortem Concentrations. J Anal Toxicol. 2015;39(3):225-8. PubMed PMID: 25540061.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Acute 3,4-methylenedioxy-N-ethylcathinone (ethylone) intoxication and related fatality: a case report with postmortem concentrations. AU - McIntyre,Iain M, AU - Hamm,Catherine E, AU - Sherrard,James L, AU - Gary,Ray D, AU - Burton,Christopher G, AU - Mena,Othon, Y1 - 2014/12/23/ PY - 2014/12/26/entrez PY - 2014/12/30/pubmed PY - 2016/3/5/medline SP - 225 EP - 8 JF - Journal of analytical toxicology JO - J Anal Toxicol VL - 39 IS - 3 N2 - A 30-year-old man reportedly ingested pills and used illicit drugs with another person. They both fell asleep that night and the following afternoon the other person found him dead. There were used hypodermic needles and a metal spoon with dark tarry substance at the death scene, and two recent puncture sites were found on his body. It was uncertain if he had a history of illicit drug use. Postmortem blood initially screened borderline positive for methamphetamine by ELISA. An alkaline drug screen-detected ethylone which was subsequently confirmed and quantified by a specific GC-MS SIM analysis following solid-phase extraction. Concentrations were determined in the peripheral blood (0.39 mg/L), central blood (0.38 mg/L), liver (1.4 mg/kg), vitreous (0.58 mg/L), urine (20 mg/L) and gastric contents (12 mg). Other compounds detected in peripheral blood were morphine (0.05 mg/L), alprazolam (<0.05 mg/L), delta-9-THC (<1 ng/mL), delta-9-carboxy-THC (3.6 ng/mL) and naproxen (<5 mg/L). A urine screen (GC-MS) also confirmed 6-monoacetylmorphine, codeine and sildenafil. The cause of death was certified due to mixed ethylone, heroin and alprazolam intoxication. The manner of death was certified as accident. SN - 1945-2403 UR - https://www.unboundmedicine.com/medline/citation/25540061/Acute_34_methylenedioxy_N_ethylcathinone__ethylone__intoxication_and_related_fatality:_a_case_report_with_postmortem_concentrations_ L2 - https://academic.oup.com/jat/article-lookup/doi/10.1093/jat/bku146 DB - PRIME DP - Unbound Medicine ER -