Isotonitazene: Fatal intoxication in three cases involving this unreported novel psychoactive substance in Switzerland.
The paper describes the first three deaths reported in Europe involved in isotonitazene consumption, a potent benzimidazole derivate opioid consumed in the recreational drug scene. Isotonitazene powder and purity determination was performed on the sample collected in the first death scene by NMR, HRMS, GC-FTIR, ATR-FTIR and GC-MS. Isotonitazene purity was determined by GC-MS analysis and proton NMR, and was defined to be above 95 % and 98 %, respectively. Quantification of isotonitazene in biological samples was performed using a targeted analysis based on SPE extraction and ultra-high performance liquid chromatography tandem mass spectrometry. The isotonitazene median concentration in femoral whole blood was 1.20ng/mL. Isotonitazene concentration in hair was similar or even lower compared to that seen in fentanyl abusers. Isotonitazene distribution in tissues converges in the brain, lungs and heart, respectively. Surprisingly, isotonitazene concentration in liver is the lowest measured for all tissues and fluids analyzed. Based on circumstantial evidence, autopsy findings and the results of the toxicological analysis, the medical examiner concluded that the cause of all three deaths was an acute intoxication with isotonitazene. Since isotonitazene toxic concentration levels are very low, the consumption of this new psychoactive drug is a real hazard for human health.
['Mueller|F|F|', 'Bogdal|C|C|', 'Pfeiffer|B|B|', 'Andrello|L|L|', 'Ceschi|A|A|', 'Thomas|A|A|', 'Grata|E|E|']
D001562:Benzimidazoles D002853:Chromatography, Liquid D062787:Drug Overdose D008401:Gas Chromatography-Mass Spectrometry D006801:Humans D009682:Magnetic Resonance Spectroscopy D008297:Male D011619:Psychotropic Drugs D017550:Spectroscopy, Fourier Transform Infrared D019966:Substance-Related Disorders D013557:Switzerland D053719:Tandem Mass Spectrometry D014018:Tissue Distribution
Hair Human tissues post-mortem redistribution Isotonitazene quantification LC-MS/MS New psychoactive substances