Abstract：
BACKGROUND: With the decline of the use of ketamine, one of the common drugs of abuse in Hong Kong, detection of ketamine-related analogues in local laboratories has been encountered.
OBJECTIVE: A brief account of the occurrence of fluorodeschloroketamine (FDCK) in forensic cases is reported through a retrospective study of all drug seizures and driving under the influence of drugs (DUID) cases since its first appearance.
METHODS: Identification of FDCK in drug seizures was achieved through gas chromatography - mass spectrometry (GC-MS) and/or liquid chromatography - diode array detection (LC-DAD) methods while its quantification was performed using gas chromatography - flame ionization detection (GC-FID). For the analysis of blood samples in DUID cases, identification and quantification were performed using LC-MS/MS by monitoring the respective transitions of FDCK and fluorodeschloronorketamine (FDCNK) using ketamine-d4 and norketamine-d4 respectively as internal standards.
RESULTS: Since its first submission in November 2018, a total of 74 drug seizure cases (151 items) and 6 drug driving cases were encountered till December 2019. Drug seizures found with FDCK were physically similar to those of ketamine seizures. The majority of items were detected with FDCK only (103 items, ∼67%) or as a mixture of FDCK with ketamine (42 items, ∼28%). The drug purity detected with either FDCK only or FDCK mixed with ketamine was high which was similar to those purity found in ketamine seizures. The blood drug concentrations of FDCK of the 6 drug driving cases were in the range of <0.002-1.1 μg/mL and other psychoactive drug(s)/metabolite(s) were also identified. Except for one case where the analysis of the metabolite, fluorodeschloronorketamine (FDCNK), was not conducted due to insufficient sample, the FDCK (FDCNK) concentrations in blood found in the 6 cases were <0.002 (0.005), 0.002 (0.002), 0.002 (0.003), 0.02 (0.035), 0.87 (0.44) and 1.1 (not determined) μg/mL.
CONCLUSIONS: With the drug seizures found with FDCK resembled in physical appearance with ketamine seizures, users might likely misuse it as ketamine. Though complicated by other drugs found, it is speculated that the two cases with higher concentration of FDCK found in blood (1.1 and 0.87 μg/mL) might have contributed to the impairment observed.
OBJECTIVE: A brief account of the occurrence of fluorodeschloroketamine (FDCK) in forensic cases is reported through a retrospective study of all drug seizures and driving under the influence of drugs (DUID) cases since its first appearance.
METHODS: Identification of FDCK in drug seizures was achieved through gas chromatography - mass spectrometry (GC-MS) and/or liquid chromatography - diode array detection (LC-DAD) methods while its quantification was performed using gas chromatography - flame ionization detection (GC-FID). For the analysis of blood samples in DUID cases, identification and quantification were performed using LC-MS/MS by monitoring the respective transitions of FDCK and fluorodeschloronorketamine (FDCNK) using ketamine-d4 and norketamine-d4 respectively as internal standards.
RESULTS: Since its first submission in November 2018, a total of 74 drug seizure cases (151 items) and 6 drug driving cases were encountered till December 2019. Drug seizures found with FDCK were physically similar to those of ketamine seizures. The majority of items were detected with FDCK only (103 items, ∼67%) or as a mixture of FDCK with ketamine (42 items, ∼28%). The drug purity detected with either FDCK only or FDCK mixed with ketamine was high which was similar to those purity found in ketamine seizures. The blood drug concentrations of FDCK of the 6 drug driving cases were in the range of <0.002-1.1 μg/mL and other psychoactive drug(s)/metabolite(s) were also identified. Except for one case where the analysis of the metabolite, fluorodeschloronorketamine (FDCNK), was not conducted due to insufficient sample, the FDCK (FDCNK) concentrations in blood found in the 6 cases were <0.002 (0.005), 0.002 (0.002), 0.002 (0.003), 0.02 (0.035), 0.87 (0.44) and 1.1 (not determined) μg/mL.
CONCLUSIONS: With the drug seizures found with FDCK resembled in physical appearance with ketamine seizures, users might likely misuse it as ketamine. Though complicated by other drugs found, it is speculated that the two cases with higher concentration of FDCK found in blood (1.1 and 0.87 μg/mL) might have contributed to the impairment observed.
摘要：
背景：随着氯胺酮使用量的减少，香港常见的滥用药物之一，在当地实验室检测到氯胺酮相关类似物。
目的：通过回顾性研究所有药物癫痫发作和药物影响下的驾驶（DUID）病例，对法医病例中氟去氯氧胺（FDCK）的发生进行了简要说明。
方法：通过气相色谱-质谱（GC-MS）和/或液相色谱-二极管阵列检测（LC-DAD）方法实现药物缉获中FDCK的鉴定，同时使用气相色谱-火焰离子化检测（GC-FID）进行定量。为了分析DUID病例的血液样本，使用LC-MS/MS,分别使用氯胺酮-d4和去甲氯胺酮-d4作为内标监测FDCK和氟去氯酮(FDCNK)的各自转变,进行鉴定和定量.
结果：自2018年11月首次提交以来，截至2019年12月，共遇到74例毒品发作病例（151项）和6例毒品驾驶病例。用FDCK发现的药物癫痫发作在物理上与氯胺酮癫痫发作相似。大多数项目仅使用FDCK检测到(103个项目，67%)或作为FDCK与氯胺酮的混合物(42项，28%）。仅用FDCK或FDCK与氯胺酮混合检测到的药物纯度很高，与氯胺酮缉获中发现的纯度相似。6例药物驾驶病例的FDCK血药浓度在<0.002-1.1μg/mL范围内，还鉴定了其他精神活性药物/代谢物。除了对代谢物的分析，氟去氯酮氯胺酮（FDCNK），由于样品不足而未进行，6例患者的血液中FDCK（FDCNK）浓度<0.002（0.005），0.002(0.002),0.002(0.003),0.02(0.035),0.87(0.44)和1.1(未测定)μg/mL。
结论：使用FDCK发现的药物发作在物理外观上与氯胺酮发作相似，用户可能会误用它作为氯胺酮。尽管被发现的其他药物复杂化了，据推测，在血液中发现的FDCK浓度较高（1.1和0.87μg/mL）的两个病例可能导致了观察到的损害。
目的：通过回顾性研究所有药物癫痫发作和药物影响下的驾驶（DUID）病例，对法医病例中氟去氯氧胺（FDCK）的发生进行了简要说明。
方法：通过气相色谱-质谱（GC-MS）和/或液相色谱-二极管阵列检测（LC-DAD）方法实现药物缉获中FDCK的鉴定，同时使用气相色谱-火焰离子化检测（GC-FID）进行定量。为了分析DUID病例的血液样本，使用LC-MS/MS,分别使用氯胺酮-d4和去甲氯胺酮-d4作为内标监测FDCK和氟去氯酮(FDCNK)的各自转变,进行鉴定和定量.
结果：自2018年11月首次提交以来，截至2019年12月，共遇到74例毒品发作病例（151项）和6例毒品驾驶病例。用FDCK发现的药物癫痫发作在物理上与氯胺酮癫痫发作相似。大多数项目仅使用FDCK检测到(103个项目，67%)或作为FDCK与氯胺酮的混合物(42项，28%）。仅用FDCK或FDCK与氯胺酮混合检测到的药物纯度很高，与氯胺酮缉获中发现的纯度相似。6例药物驾驶病例的FDCK血药浓度在<0.002-1.1μg/mL范围内，还鉴定了其他精神活性药物/代谢物。除了对代谢物的分析，氟去氯酮氯胺酮（FDCNK），由于样品不足而未进行，6例患者的血液中FDCK（FDCNK）浓度<0.002（0.005），0.002(0.002),0.002(0.003),0.02(0.035),0.87(0.44)和1.1(未测定)μg/mL。
结论：使用FDCK发现的药物发作在物理外观上与氯胺酮发作相似，用户可能会误用它作为氯胺酮。尽管被发现的其他药物复杂化了，据推测，在血液中发现的FDCK浓度较高（1.1和0.87μg/mL）的两个病例可能导致了观察到的损害。
