Methamphetamine in hair and interpretation of forensic findings in a fatal case

Beránková, Kateřina; Habrdova, Vilma; Balı́ková, Marie; Strejc, P

doi:10.1016/j.forsciint.2005.04.037

Cited by 25 publications

(10 citation statements)

References 10 publications

(13 reference statements)

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“…In postmortem toxicology, hair analysis may be useful for the assessment of naïve 12 or chronic 13 MAMP intake, in order to evaluate a subject’s tolerance. Analysis of maternal and neonatal hair is also a valid tool to assess intrauterine exposure to MAMP 14 .…”

Section: Discussionmentioning

confidence: 99%

Incorporation of methamphetamine and amphetamine in human hair following controlled oral methamphetamine administration

Polettini

Cone²,

Gorelick

et al. 2012

Analytica Chimica Acta

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Background Although hair testing is well established for the assessment of past drug exposure, uncertainties persist about mechanisms of drug incorporation into hair and interpretation of results. The aim of this study was to administer methamphetamine (MAMP) under controlled conditions as a model drug to investigate drug incorporation into human hair. Material and Methods Seven volunteers with a history of stimulant use received 4×10 mg (low) doses of sustained release S-(+)-MAMP HCl within one week, with weekly head hair samples collected by shaving. 3 weeks later, 4 of them received 4×20 mg (high) doses. After extensive isopropanol/phosphate buffer washing of the hair, MAMP and its metabolite amphetamine (AMP) concentrations were determined in all weekly hair samples by LC-MS-MS in selected reaction monitoring mode with the undeca- and deca-deuterated drugs, respectively, as internal standards (LLOQ, 0.005 ng/mg). Results MAMP Tmax occurred from 1 to 2 weeks after both doses, with Cmax ranging from 0.6–3.5 ng/mg after the low and 1.2–5.3 ng/mg after the high MAMP doses. AMP Cmax in hair was 0.1–0.3 ng/mg and 0.2–0.5 ng/mg, respectively, for low and high doses. Highly dose–related concentrations within subjects, but large variability between subjects were observed. MAMP concentrations were above the 0.2 ng/mg cutoff for at least two weeks following administration of both low and high doses. The overall AMP/MAMP ratio ranged from 0.07 to 0.37 with a mean value of 0.15±0.07, and a median of 0.13. The percentage of MAMP and AMP removed with the washing procedure decreased with time after administration. A strong correlation was found between area under the curve of MAMP (r2=0.90, p=0.00) and AMP (r2=0.94, p=0.00) concentrations calculated for the 3-week period following administration and the total melanin concentration in hair. Significant correlations were observed also between Cmax and melanin. Conclusions This study demonstrated that despite large inter-individual differences, the incorporation of MAMP and AMP into hair is dose-related with much of the observed scatter of MAMP and AMP concentrations explained by melanin concentration in hair.

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Section: Discussionmentioning

confidence: 99%

Incorporation of methamphetamine and amphetamine in human hair following controlled oral methamphetamine administration

Polettini

Cone²,

Gorelick

et al. 2012

Analytica Chimica Acta

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“…It is now well reported in humans and several other animal models that methamphetamine intoxication is associated with a number of adverse consequences including agitation, aggression, hyperthermia, delirium, cardiac ischemia, seizures, strokes, rhabdomyolysis, dysfunction of the liver, heart, kidney, or even death by overdose [12-17]. So far, however, incidences of methamphetamine intoxication in dogs seem to have had relatively poorly covered, with only one intoxication case report presented in 1998 [18], two toxicity studies reported in 1965 [19] and 1982 [20], three pharmacokinetic studies conducted from 1995 to 1997 [21-23].…”

Section: Introductionmentioning

confidence: 99%

Methamphetamine intoxication in a dog: case report

Pei

Zhang²

2014

BMC Vet Res

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BackgroundMethamphetamine abuse has undergone a dramatic worldwide increase, and represents a significant and global issue for public health. Incidents of methamphetamine intoxication and death in humans are relatively commonplace. Because of its increasing illicit availability, together with legitimate use in human medicine, accidental or intentional exposure to methamphetamine in dogs is becoming a more likely scenario.Case presentationA 3-year-old, 3.7 kg intact female Miniature Poodle who had been intentionally fed an unknown amount of a crystalline-like substance developed extreme agitation, seizures, tachycardia, hyperthermia, hypertension, disseminated intravascular coagulation (DIC), bloody diarrhea, and dilated pupils. Blood work revealed leukocytosis, erythropenia, lymphocytosis, thrombocytopenia, coagulation abnormalities, but all to a mild extent, together with mild elevation in both alanine aminotranferease (ALT) and alkaline phosphatase (ALKP), and a mild decreased in glucose. Radiologic diagnosis revealed generalized, severe distension of the stomach and small intestinal tract with air. Immunochromatographic screening tests and gas chromatography mass spectrometry analysis confirmed methamphetamine intoxication and revealed concentrations of methamphetamine in blood and urine of 0.32 μg/mL and 2.35 μg/mL respectively. The dog demonstrated progressive improvement after supportive care, with the high fever resolved over the initial 24 hours of hospitalization, and agitation was successfully controlled beyond 48 hours after initial hospitalization. Hemostatic abnormalities were progressive improved after heparin therapy and supportive care. By the sixth day of hospitalization the dog was clinically well, and all laboratory data had returned to normal with the exception of a mild elevateion of ALKP.ConclusionTo the authors’ knowledge, this is the second case report of methamphetamine intoxication in dogs presented in veterinary practice in open literature so far. Although rare, methamphetamine intoxication should be considered as a differential diagnosis in dogs with a toxic substance ingestion history and with typical nervous and cardiovascular system symptoms. In such cases rapid diagnosis and aggressive intervention is important for prognosis. Blood methamphetamine concentration may be a helpful value for assessment of the severity of intoxication and prediction of clinical outcomes.

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“…Demonstrating alcoholic cardiomyopathy by biopsy in a human experimental population, a Barcelona group [2,3] was also able to demonstrate a correspondence between skeletal myopathy and cardiomyopathy. There is a substantial animal literature [4–7] as well as strongly suggestive human case reports [8,9,10,11] and a postmortem survey (12) relating to cardiotoxicity from methamphetamine. However, at present there is neither causal demonstration nor prevalence statistics available in humans for the connection.…”

Section: Introductionmentioning

confidence: 99%

“…Numerous references acknowledge the likelihood of cardiomyopathic changes with methamphetamine use, but generally as one among many varied cardiovascular effects and injuries [18]. While methamphetamine‐associated cerebrovascular accident, both ischemic and hemorrhagic [11,16], is a concern associated with the vasoconstrictive and hypertensive effects of methamphetamine [19,20] cardiac consequences are less clear. The existence of human methamphetamine cardiomyopathy may be inferred from case reports [8–10,21], but the association is not conclusive.…”

Section: Introductionmentioning

confidence: 99%

Electrocardiographic abnormalities in methamphetamine abusers

Haning

Goebert

2007

Addiction

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Aims Although many adverse cardiovascular outcomes are mentioned in conjunction with methamphetamine use, a causal relationship between methamphetamine use and arrhythmia or cardiomyopathy has not been demonstrated in man. Clinical experience with methamphetamine users suggested a higher incidence of electrocardiographic abnormalities. This study seeks to quantify that incidence, among subjects enrolled in a study of adults with methamphetamine dependence. Methods Electrocardiograms obtained during screening in a previous clinical trial were examined. The study population (n = 158) of adults with methamphetamine dependence [Diagnostic and Statistical Manual version IV (DSM IV-TR)] was drawn from five sites across the United States, recruited in the interval 2002-03. Results A significant variance from the normal population was noted in the electrocardiograms of the study cohort. Among the abnormalities was a prolongation of the QTc beyond 440 ms in 27.2% of the group. QTc prolongation to this extent poses a particular risk for ventricular arrhythmias, most notably torsades de pointes. Conclusions We believe that this is the first demonstration of clinically significant QTc prolongation in a methamphetamine-using population, and that this has implications for the types of arrhythmias for which this population is at risk. It may further provide a marker for risk of cardiomyopathy. The fact of electrocardiographic changes with potential cardiac risks may be useful in a motivational interviewing approach, in challenging the methamphetamine user's basis for continuing use.

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Methamphetamine in hair and interpretation of forensic findings in a fatal case

Cited by 25 publications

References 10 publications

Incorporation of methamphetamine and amphetamine in human hair following controlled oral methamphetamine administration

Incorporation of methamphetamine and amphetamine in human hair following controlled oral methamphetamine administration

Methamphetamine intoxication in a dog: case report

Electrocardiographic abnormalities in methamphetamine abusers

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