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Role of toxicological determinations of amphetamines and cannabinoids in hair of adolescent patients in cardiologic diagnostic management

Published online by Cambridge University Press:  23 May 2011

Małgorzata Kłys*
Affiliation:
Department of Forensic Medicine Cracow, Jagiellonian University Medical College, Poland
Lesław Szydłowski
Affiliation:
Department of Pediatric Cardiology, Silesian University, Katowice, Poland
Sebastian Rojek
Affiliation:
Department of Forensic Medicine Cracow, Jagiellonian University Medical College, Poland
*
Correspondence to: Dr M. Kłys, Department of Forensic Medicine, Jagiellonian University Medical College, 16 Grzegorzecka Street, 31-531 Krakow, Poland. Tel: +48 12 421 08 59; Fax: +48 12 421 11 13; E-mail: mpklys@cyf-kr.edu.pl

Abstract

Background

Parental suspicions that the child may possibly take narcotics may be substantiated by hair analysis, which may not only identify the narcotic abuse profile, but also define the minimum period of narcotic usage.

Objective

A toxicological hair analysis aiming at detecting the presence of amphetamines and cannabinoids in children with cardiac complaints of unclear aetiology, with a view of establishing a diagnosis.

Material and method

The authors analysed hair samples collected from the occipital region of three adolescent patients for the presence of substances of abuse – amphetamines and cannabinoids. Hair strands were subjected to segmentation and chemical processing and subsequently analysed by liquid chromatography–mass detection method.

Results

Indicating the presence of amphetamines and cannabinoids in hair samples, the toxicological analysis allowed for explaining cardiac complaints and personality changes in adolescent patients, with the said changes being associated with addiction to the above xenobiotics extending over some period.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2011

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References

1. Szukalski, B. Narcotics. Compendium of knowledge about drugs of abuse. Institute of Psychiatry and Neurology, Warszawa, 2005.Google Scholar
2. Robson, PH. Forbidden drugs: understanding drugs and why people take them. Medycyna Praktyczna, Kraków, 1997.Google Scholar
3. Kała, M, Adamowicz, P, Chudzikiewicz, E, et al. Substances acting similarly to alcohol in the organism of drivers. Probl Forensic Sci 2005; 62: 133140.Google Scholar
4. Kłys, M, Bystrowska, B, Bujak-Giżycka, B, Konopka, T, Rojek, S. Amphetamine and derivatives related deaths in the aspect of forensic toxicology. Przeg Lek 2003; 60: 239244.Google ScholarPubMed
5. Kłys, M, Rojek, S, Woźniak, K, Rzepecka-Woźniak, E. Fatality due to the use of a designer drug MDMA (Ecstasy). Leg Med 2007; 9: 185191.CrossRefGoogle Scholar
6. Derlet, RW, Rice, P, Horowitz, BZ, Lord, RV. Amphetamine toxicity: experience with 127 cases. J Emerg Med 1989; 7: 157161.CrossRefGoogle ScholarPubMed
7. Alsabagh, KH, Vadstrup, S. Acute coronary syndrome after a single dose of amphetamine. Ugeskr Laeger 2007; 169: 424426.Google ScholarPubMed
8. Berman, S, O'Neill, J, Fears, S, Bartzokis, G, London, ED. Abuse of amphetamines and structural abnormalities in the brain. Ann N Y Acad Sci 2008; 1141: 195220.CrossRefGoogle ScholarPubMed
9. Raviña, P, Quiroga, JM, Raviña, T. Hyperkalemia in fatal MDMA (‘ecstasy’) toxicity. Int J Cardiol 2004; 93: 307308.CrossRefGoogle ScholarPubMed
10. Brennan, K, Shurmur, S, Elhendy, A. Coronary artery rupture associated with amphetamine abuse. Cardiol Rev 2004; 12: 282283.CrossRefGoogle ScholarPubMed
11. Frishman, WH, Del Vecchio, A, Sanal, S, Ismail, A. Cardiovascular manifestations of substance abuse: part 2: alcohol, amphetamines, heroin, cannabis, and caffeine. Heart Dis 2003; 5: 253271.CrossRefGoogle ScholarPubMed
12. Smith, HJ, Roche, AH, Jausch, MF, Herdson, PB. Cardiomyopathy associated with amphetamine administration. Am Heart J 1976; 91: 792797.CrossRefGoogle ScholarPubMed
13. Westover, AN, Nakonezny, PA, Haley, RW. Acute myocardial infarction in young adults who abuse amphetamines. Drug Alcohol Depend 2008; 96: 4956.CrossRefGoogle ScholarPubMed
14. Yeo, KK, Wijetunga, M, Ito, H, et al. The association of methamphetamine use and cardiomyopathy in young patients. Am J Med 2007; 120: 165167.CrossRefGoogle ScholarPubMed
15. Mcevoy, AW, Kitchen, ND, Thomas, DG. Intracerebral haemorrhage and drug abuse in young adults. Br J Neurosurg 2000; 14: 449454.CrossRefGoogle ScholarPubMed
16. Kłys, M, Konopka, T, Rojek, S. Intracerebral haemorrhage associated with amphetamine. J Anal Toxicol 2005; 29: 577581.CrossRefGoogle ScholarPubMed
17. Bach, L, Morland, H. Acute cardiovascular fatalities following cannabis use. Forensic Sci Int 2001; 124: 200203.CrossRefGoogle Scholar
18. Kintz, P, Tracqui, A, Mangin, P. Detection of drugs in human hair for clinical and forensic applications. Int J Legal Med 1992; 105: 14.CrossRefGoogle ScholarPubMed
19. Gaillard, Y, Pepin, G. Testing hair for pharmaceuticals. J Chromatogr B Biomed Sci Appl 1999; 733: 231246.CrossRefGoogle ScholarPubMed
20. Sachs, H. Forensic applications of hair analysis in drug testing. In: Kintz P (ed). Drug testing in hair. CRC Press, Boca Raton, FL, 1996, pp 211222.Google Scholar
21. Sachs, H, Kintz, P. Testing for drugs in hair. Critical review of chromatographic procedures since 1992. J Chromatogr B Analyt Technol Biomed Life Sci 1998; 713: 147161.CrossRefGoogle ScholarPubMed
22. Kronstrand, R, Scott, K. Drug incorporation into hair. In: Kintz P (ed). Analytical and practical aspects of drug testing in hair. CRC Press Taylor & Francis Group, Boca Raton, FL, 2007, pp 12.Google Scholar
23. www.soht.org – Consensus on hair analysis.Google Scholar
24. Kłys, M, Rojek, S, Kulikowska, J, Bożek, E. Usefulness of multiple opiate and amphetamine analysis in hair segments under methadone therapy using LC-APCI-MS-MS. Forensic Toxicol 2007; 25: 6975.CrossRefGoogle Scholar
25. Kłys, M, Rojek, S, Kulikowska, J, Bożek, E, Ścisłowski, M. Usefulness of multi-parameter opiates–amphetamines–cocainics analysis in hair of drug users for the evaluation of an abuse profile by means of LC–APCI–MS–MS. J Chromatogr B Analyt Technol Biomed Life Sci 2007; 854: 299307.CrossRefGoogle ScholarPubMed
26. Rojek, S, Kłys, M. Analysis of 9-THC and its metabolites 11-0H-9-THC and THC–COOH in blood by gas chromatography coupled to tandem mass spectrometry (GC–MS–MS) and its application to medico-legal investigations. Probl Forensic Sci 2007; 70: 173178.Google Scholar
27. Diercks, DB, Kirk, JD, Turnipseed, SD, Amsterdam, EA. Evaluation of patients with methamphetamine- and cocaine-related chest pain in a chest pain observation unit. Crit Pathw Cardiol 2007; 6: 161164.CrossRefGoogle Scholar
28. Jacobs, W. Fatal amphetamine-associated cardiotoxicity and its medicolegal implications. Am J Forensic Med Pathol 2006; 27: 156160.CrossRefGoogle ScholarPubMed
29. Marks, DH. Cardiomyopathy due to ingestion of Adderall. Am J Ther 2008; 15: 287289.CrossRefGoogle ScholarPubMed
30. Rothe, M, Pragst, E, Spiegel, K, Harrach, T, Fischer, K, Kunkel, J. Hair concentrations and self-reported abuse history of 20 amphetamine and ecstasy users. Forensic Sci Int 1997; 9: 111128.CrossRefGoogle Scholar