As synthetic cannabinoid receptor agonists (SCRA) are gaining popularity globally, clinicians have to understand that intoxication caused by vaping SCRA is not detected by commonly available tests. He confirmed that he had been vaping an electronic cigarette (e-cigarette) earlier that day just before the onset of his symptoms. Metabolic acidosis (1/3, 0/7) and respiratory acidosis (1/3, 0/7), All 10 patients recovered with supportive care, including intubation and ventilation for one case. In 3 cases ADB-BUTINACA was the only substance detected, while in seven other substances of misuse were also detected including other SCRA, opioids, benzodiazepines cocaine and pregabali

To evaluate whether the changes of coordinative functions by CNS damages were due to test substances, rota-rod test was performed using Rota-rod apparatus (Daejong, Seoul, Korea). The test apparatus for the locomotor activity test was designed to measure locomotor activity automatically using UV system (AM 1051, Benwick Electronics, Benwick, UK) when experimental animals moved in the chamber. In both tests, a group of mice were treated with negative control (vehicle, 1 mg/kg, i.p.), positive control (methamphetamine, 1 mg/kg, i.p.), or one of the three doses of test substances (0.1, 1, 5 mg/kg, i.p.) once every other day for 10 day

While the patient’s symptoms strongly suggest the inhalation of ADB-BUTINACA, it is worth considering that these symptoms could also be attributed to nicotine exposure, as the symptoms partially overlap with known nicotine effect

During the death scene examination, multiple cigarette butts without filters were found in an ashtray; also found were alcohol bottles, an unopened box of nebivolol-containing drug, and 18 g of unrecognizable herbal residue in a cigarette bo

The same procedure was then applied to the mice once every day for 5 days. It was considered as coordination disturbance when mice fell from the test apparatus within 2 min. Mice that remained their position on the running apparatus at 10 rpm for at least 2 min were selected for further evaluation.
Table of Conten

High resolution mass spectrometry such as LC-QTOF-MS allows the detection and identification of a broad spectrum of recreational drugs, including new psychoactive substances. A point-of-care drugs of abuse (DOA) test was initially performed on the urine of the patient. He confirmed drinking 750 ml energy drink without any further consumption of food and using an e-cigarette from Gaziantep, Turkey 10 seconds before the onset of his first symptoms. He usually smokes a pack of cigarettes a day and sometimes smokes e-cigarettes. Combined with non-specific, transient symptoms, clinical recognition of SCRA intoxication is challenging .
Data availability
The intensity is plotted against the retention time for both chromatograms, demonstrating the adb butinaca presence and elution profiles of nicotine and ADB-BUTINACA in the analysed vape liquid sample. LC-QTOF-MS Chromatograms of Nicotine (Top) and ADB-BUTINACA (Bottom) in the Vape Liquid used by the patient. The LC-QTOF-MS analysis showed that the e-liquid contained nicotine and ADB-BUTINACA (Fig. 1). Because the point-of-care DOA test is generally not able to detect synthetic recreational drug substances, the liquid of the e-cigarette was thereafter screened using liquid chromatography-quadrupole time-of-flight mass spectrometry (LC-QTOF-MS) on the Waters™ Xevo G3 QTOF MS system. After eating a light meal and drinking caffeinated sports drinks at the ER, the nausea complaints of the patient were reduced and the patient was discharged hom

Similarly, precursor ion identified at m/z 380 (B19/B21, B23/B25) was 16 Da higher than the 4F-MDMB-BINACA, indicating monohydroxylation at the butyl side chain (B19/B21) and indazole (B23/B25) moieties with product ions m/z 145 and 161, respectively. Metabolites identified at m/z 366 (B8, B9, B13), which was 16 Da higher than the 4F-MDMB-BINACA ester hydrolysis metabolite (B22), confirmed monohydroxylation upon ester hydrolysis. Death involving these drugs have been reported [5,6,7,8,9], and this raises public health and social concerns. Due to their similar physiological effects to the principal psychoactive component of cannabis, Δ9-tetrahydrocannabinol (THC), SCBs are gaining popularity and are often abused as recreational drugs. The fact that similar 4F-MDMB-BINACA and ethanol concentrations were detected in the postmortem blood samples of both victims suggests that both substances played a role in the fatal outcom

Although there were reports on the metabolism of 4F-MDMB-BINACA using in-vivo and various in-vitro models, studies were either conducted using small in-vivo sample size such as 1 to 4 samples [5, 29] or in closed environments such as forensic psychiatric wards and prisons . The hepatic cell line HepG2 is often used as an initial screen as it is known to produce high reproducibility results with relatively stable enzyme concentration, although they are limited by the low-level expression of several metabolizing enzymes, including the cytochrome P450 (CYP) class of proteins [17, 18]. In-vitro metabolism studies are generally used to complement these data using perfused organs, tissue or cell cultures and microsomal preparations amongst which pooled human liver microsomes (HLM) have been frequently used to elucidate metabolism of SCBs [12,13,14,15,16]. Since most SCBs are found extensively in metabolized forms in urine, the identification of metabolites is of vital importance for forensic and clinical toxicologists. Identifying SCB intake and its correlating specific adverse effects require rapid elucidation of these SCBs. The proliferation of SCBs has become a global challenge as new compounds are rapidly introduced into the illegal drug market to evade existing drug law