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Abstract：
OBJECTIVE: The potent hallucinogenic drug 25I-NBOMe has recently emerged on the drug market. We present a case with analytically confirmed 25I-NBOMe intoxication from the prospective study \"SPICE II Plus\".
METHODS: Because of a severe headache a 42-year-old man took one sip of a pediatric analgesic syrup, which had been refilled with a self-made solution of 25I-NBOMe in ethanol. Thirty minutes later restlessness occurred. On arrival in the emergency department mydriasis, strong sweating, disorientation, and agitation were noticed. Within short time the patient developed severe agitation, coenesthesia, and complex hallucinations. In blood serum samples obtained at admission revealed the presence of 25I-NBOMe (34 ng/mL), 2C-I (12 ng/mL) and 25I-NBOH (<1 ng/mL) (LC-ESI-MS/MS). The presumed analgesic syrup contained 25I-NBOMe (2800 μg/mL), and besides ethanol no other compounds were detected. After six hours, the symptoms resolved without further complications.
CONCLUSIONS: This is a unique case of an analytically confirmed, accidental ingestion of 25I-NBOMe in a drug naïve adult. The finding of 2C-I in the serum sample 50 minutes after intake indicates a fast metabolic breakdown of 25I-NBOMe due to first-pass metabolism.
METHODS: Because of a severe headache a 42-year-old man took one sip of a pediatric analgesic syrup, which had been refilled with a self-made solution of 25I-NBOMe in ethanol. Thirty minutes later restlessness occurred. On arrival in the emergency department mydriasis, strong sweating, disorientation, and agitation were noticed. Within short time the patient developed severe agitation, coenesthesia, and complex hallucinations. In blood serum samples obtained at admission revealed the presence of 25I-NBOMe (34 ng/mL), 2C-I (12 ng/mL) and 25I-NBOH (<1 ng/mL) (LC-ESI-MS/MS). The presumed analgesic syrup contained 25I-NBOMe (2800 μg/mL), and besides ethanol no other compounds were detected. After six hours, the symptoms resolved without further complications.
CONCLUSIONS: This is a unique case of an analytically confirmed, accidental ingestion of 25I-NBOMe in a drug naïve adult. The finding of 2C-I in the serum sample 50 minutes after intake indicates a fast metabolic breakdown of 25I-NBOMe due to first-pass metabolism.
摘要：
目的：最近在药物市场上出现了有效的致幻药物25I-NBOMe。我们从前瞻性研究“SPICEIIPlus”中分析证实了25I-NBOMe中毒的病例。
方法：由于一名42岁的男子严重头痛，他喝了一口小儿镇痛糖浆，用乙醇中的25I-NBOMe自制溶液重新填充。30分钟后出现躁动。一到达急诊室，散瞳，强烈的出汗，迷失方向，注意到了激动。在短时间内，患者出现严重的躁动，麻醉,和复杂的幻觉.在入院时获得的血清样本中显示存在25I-NBOMe（34ng/mL），2C-I(12ng/mL)和25I-NBOH(<1ng/mL)(LC-ESI-MS/MS)。假定的镇痛糖浆含有25I-NBOMe（2800μg/mL），除乙醇外，没有检测到其他化合物。六个小时后,症状缓解,无进一步并发症.
结论：这是一个分析证实的独特案例，在一个幼稚的成年人中意外摄入25I-NBOMe。摄入后50分钟血清样品中2C-I的发现表明25I-NBOMe由于首过代谢而快速代谢分解。
方法：由于一名42岁的男子严重头痛，他喝了一口小儿镇痛糖浆，用乙醇中的25I-NBOMe自制溶液重新填充。30分钟后出现躁动。一到达急诊室，散瞳，强烈的出汗，迷失方向，注意到了激动。在短时间内，患者出现严重的躁动，麻醉,和复杂的幻觉.在入院时获得的血清样本中显示存在25I-NBOMe（34ng/mL），2C-I(12ng/mL)和25I-NBOH(<1ng/mL)(LC-ESI-MS/MS)。假定的镇痛糖浆含有25I-NBOMe（2800μg/mL），除乙醇外，没有检测到其他化合物。六个小时后,症状缓解,无进一步并发症.
结论：这是一个分析证实的独特案例，在一个幼稚的成年人中意外摄入25I-NBOMe。摄入后50分钟血清样品中2C-I的发现表明25I-NBOMe由于首过代谢而快速代谢分解。
