@article{ref1,
title="A fatal case of poisoning related to new cathinone designer drugs, 4-methoxy PV8, PV9, and 4-methoxy PV9, and a dissociative agent, diphenidine",
journal="Legal medicine (Elsevier)",
year="2015",
author="Kudo, Keiko and Usumoto, Yosuke and Kikura-Hanajiri, Ruri and Sameshima, Naomi and Tsuji, Akiko and Ikeda, Noriaki",
volume="17",
number="5",
pages="421-426",
abstract="A woman in her thirties was found dead on a bed. Considerable amounts of &quot;aroma liquid&quot; and &quot;bath salt&quot; products and hypnotic drug tablets were scattered beside the bed. Autopsy showed pulmonary congestion and edema. Gas chromatography-mass spectrometry (GC-MS) and liquid chromatography-mass spectrometry (LC-MS) analyses of &quot;aroma liquid&quot; and &quot;bath salt&quot; products showed the presence of new cathinone designer drugs, 4-methoxy PV8 (4-methoxy PHPP), PV9 (α-POP), and 4-methoxy PV9 (4-methoxy α-POP), and a dissociative agent, diphenidine. Drug screening in stomach contents, blood and hydrolyzed urine of the woman by GC-MS and liquid chromatography-tandem mass spectrometry (LC-MS/MS) revealed the presence of the above 4 types of drugs and 3 types of benzodiazepines, triazolam, flunitrazepam, and nitrazepam, and their metabolites. The above 7 drugs and 3 benzodiazepine metabolites were simultaneously determined by LC-MS/MS after modified QuEChERS (Quick, Easy, Cheap, Effective, Rugged, Safe) extraction using diazepam-d5 as the internal standard. The concentrations of 4-methoxy PV8, PV9, 4-methoxy PV9, and diphenidine in the femoral blood were 2.69, 0.743, 0.261, and 1.38μg/ml, respectively, which were significantly higher than concentrations reported in previous cases. Alcohol concentration in the femoral blood was 1.52mg/ml. Based on the pathological and toxicological findings, the cause of death was determined to be 3 types of cathinone drugs, 4-methoxy PV8, PV9, and 4-methoxy PV9, and diphenidine poisoning under the influence of 3 benzodiazepines and alcohol.<p /> <p>Language: en</p>",
language="en",
issn="1344-6223",
doi="10.1016/j.legalmed.2015.06.005",
url="http://dx.doi.org/10.1016/j.legalmed.2015.06.005"
}