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Fecha Publicación: 2013-12-20
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Osorio, J. H. (2013). Implicaciones metabólicas y clínicas de algunas drogas de diseño. Biosalud, 12(2), 110–117. Recuperado a partir de https://revistasojs.ucaldas.edu.co/index.php/biosalud/article/view/4699
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Antecedentes: Las drogas de diseño del tipo anfetamina, o de benzil y fenil piperazina, o del tipo pirrolidinfenona, producen sentimientos de euforia, energía y deseos de socializar, por eso son conocidas como rave drugs o drogas de club. A pesar de que los consumidores aducen que son drogas seguras, estudios experimentales en biomodelos y de tipo epidemiológico en humanos, indican riesgos potenciales para quien las usa. Materiales y Métodos: El presente artículo de revisión analiza, cualitativamente, la literatura científica disponible en las bases de datos Science Direct y PUBMED, relacionada con el metabolismo de estas drogas recreacionales y sus implicaciones en salud. Resultados: Se obtuvo información pertinente relacionada con los objetivos propuestos, por lo cual puede clasificarse en 2 secciones a saber: metabolismo de las drogas de diseño e implicaciones clínicas de su consumo. Conclusión: Las vías metabólicas que involucran isoenzimas P450 son responsables de la degradación hepática de las drogas de diseño. Existen riesgos potenciales para quien las consume, entre los que se encuentran el síndrome de serotonina, hepatotoxicidad, neurotoxicidad y psicopatología.
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Drug Enforcement Administration. An overview of club drugs. Drug Intelligence Brief. 2000. Disponible en: http://www.usdoj.gov/dea/pubs/intel/
Lenton S, Boys A, Norcross K. Raves, drugs and experience: drug use by a sample of people who attend raves in Western Australia. Addiction 1997; 92:1327-37.
Jansen KL. A review of the nonmedical use of ketamine: use, users and consequences. J Psychoactive Drugs 2000; 32:419-33.
Weir E. Raves: A review of the culture, the drugs and the prevention of harm. CMAJ 2000; 162:1843-8.
Abanades S, Farre M. Drogas de diseño. Med Clin (Barc) 2003; 121:38.
Riley SC, James C, Gregory D, Dingle H, Cadger M. Patterns of recreational drug use at dance events in Edinburgh, Scotland. Addiction 2001; 96:1035-47.
Winstock AR, Griffiths P, Stewart D. Drugs and the dance music scene: a survey of current drug use patterns among a sample of dance music enthusiasts in the UK. Drug Alcohol Depend 2001; 64:9-17.
Tossmann P, Boldt S, Tensil MD. The use of drugs within the techno party scene in European metropolitan cities. Eur Addict Res 2001; 7:2-23.
Vivas NM, Màrmol F, Sallés J, Badia A, Dierssen M. Action on noradrenergic transmission of an anticholinesterase: 9-amino-1,2,3,4-tetrahydroacridine. Neuropharmacology 1995; 34(4):367-75.
Benedict RG, Tyler VE. Blueing in Conocybe, Psilocybe, and a Stropharia species and the detection of psilocybin. Lloydia 1967; 30:149-157.
Bogusz MJ, Maier RD, Schafer AT, Erkens M. Honey with Psilocybe mushrooms: a revival of a very old preparation on the drug market? Int. J. Legal Med 1998; 111:147-150.
Kulkarni SV, Mughani YA, Onbol EH, Kempegowda P. Khat and stroke. Ann Indian Acad Neurol 2012; 15(2):139-40.
Lurie Y, Gopher A, Lavon O, Almog S, Sulimani L, Bentur Y. Severe paramethoxymethamphetamine (PMMA) and paramethoxyamphetamine (PMA) outbreak in Israel. Clin Toxicol (Phila) 2012; 50(1):39-43.
Loor R, Lingenfelter C, Wason PP, Tang K, Davoudzadeh D. Multiplex assay of amphetamine, methamphetamine, and ecstasy drug using CEDIA technology. J Anal Toxicol 2002; 26(5):267-73.
Staack RF, Maurer HH. Metabolism of designer drugs of abuse. Curr Drug Metab 2005; 6(3):259-74.
Beck O, Villén T. Drugs of abuse testing safer and safer and more complete. Lakartidningen 2011; 108(45):2300-3.
Huerta-Fontela M, Pineda O, Ventura F, Galceran MT. New chlorinated amphetamine-type-stimulants disinfection-by-products formed during drinking water treatment. Water Res 2012; 46(10):3304-14.
Albertson T, Walby W, Derlet R. Stimulant-induced pulmonary toxicity. Chest 1995; 108:1140-9.
Mendelson J, Jones RT, Upton R, et al. Methamphetamine and ethanol interaction in man. Clin Pharmacol Ther 1995; 57:559-68.
Kalant H. The pharmacology and toxicology of “ecstasy” (MDMA) andrelated drugs. Can Med Assoc J 2001; 165:917-928.
De Boer D, Bosman IJ, Hidvegi E, et al. Piperazine-like compounds: a newgroup of designer drugsof-abuse on the European market. Forensic SciInt 2001; 121:47-56.
Staack RF, Fritschi G, Maurer HH. Studies on the metabolism and the toxicological analysis of the new piperazine-like designer drug Nbenzylpiperazine in urine using gas chromatography-mass spectrometry. J Chromatogr B 2002; 773:35-46.
Staack RF, Fritschi G, Maurer HH. New designer drug 1-(3-trifluoromethylphenyl) piperazine (TFMPP): gas chromatography/mass spectrometry and liquid chromatography/mass spectrometry studies on its phase I and II metabolism and on its toxicological detection in rat urine. J Mass Spectrom 2003; 38:971-981.
Rotzinger S, Fang J, Coutts RT, et al. Human CYP2D6 and metabolism of m chlorophenylpiperazine. Biol Psychiatry 1998; 44:1185-1191.
Staack RF, Paul LD, Springer D, et al. Cytochrome P450 dependent metabolism of the new designer drug 1-(3-trifluoromethylphenyl) piperazine (TFMPP). In vivo studies in Wistar and Dark Agouti rats as well as in vitro studies in human liver microsomes. Biochem Pharmacol 2004; 67:235-244.
Maurer HH, Kraemer T, Springer D, Staack RF. Chemistry, pharmacology, toxicology and hepatic metabolism of designer drugs of the amphetamine (ecstasy), piperazine and pyrrolidinophenone types: a synopsis. Ther Drug Monit 2004; 26(2):127-31.
Springer D, Peters FT, Fritschi G, et al. Studies on the metabolism and toxicological detection of the new designer drug 4_-methyl alphapyrrolidinopropiophenone in urine using gas chromatographymass spectrometry. J Chromatogr B 2002; 773:25-33.
Springer D, Fritschi G, Maurer HH. Metabolism and toxicological detection of the new designer drug 3_,4_-methylenedioxy-alphapyrrolidinopropiophenone studied in urine using gas chromatographymass spectrometry. J Chromatogr B 2003; 793:377-388.
Springer D, Fritschi G, Maurer HH. Metabolism and toxicological detection of the new designer drug 4-methoxy-pyrrolidinopropiophenone studied in rat urine using gas chromatography-mass spectrometry. J Chromatogr B 2003; 793:331-342.
Ricca V, Castellini G, Mannucci E, et al. Amphetamine derivatives and obesity. Appetite 2009; 52(2):405-9.
Freo U. Cerebral metabolic effects of serotonin drugs and neurotoxins. Life Sci 1996; 59:877-891.
Marek GJ, Aghajanian GK. LSD and the phenethylamine hallucinogen DOI are potent partial agonists at 5-HT2A receptors on interneurons in rat piriform cortex. J Pharmacol Exp Ther 1996; 278(3):1373-82.
Franz X. Vollenweidera U, Ralph P, et al. Effects of high amphetamine dose on mood and cerebral glucose metabolism in normal volunteers using positron emission tomography. Psychiatry Res Neuroimag 1998: 83(3):149-162.
Griffith JD, Cavanaugh J, Held J, Oates JA. Dextroamphetamine. Evaluation of psychomimetic properties in man. Archives of General Psychiatry 1972; 26:97-100.
Silverstone T, Wells B, Trenchart E. Differential dose-response effects of dexamphetamine sulphate on hunger and mood in human volunteers. Psychopharmacology 1983; 79:242-45.
Hall W, Hando J, Darke S, Ross J. Psychological morbidity and route of administration among amphetamine users in Australia. Addiction 1996; 91:81-7.
Mouhaffet A, Madu E, Satmary W, et al. Cardiovascular complications of cocaine. Chest 1995; 107:1426-34.
Henry JA, Jeffreys KJ, Dawling S. Toxicity and death from 3,4 methylenedioxymethamphetamine (“ectasy”). Lancet 1992; 340:384-7.
Smit A, Wieling W, Voogel A, et al. Orthostatic hypotension due to suppression of vasomotor flow after amphetamine intoxication. Mayo Clin Proc 1996; 71:1067-70.
Mittleman MA, Mintzer D, Maclure M. Triggering of myocardial infarction by cocaine. Circulation 1999; 99:2737-41.
Bashour T. Acute myocardial infarction resulting from amphetamine abuse: spasm thrombus interplay? Am Heart J 1994; 128:1237-8.
Joffe BD, Broderick TM, Leier CV. Cocaine induced coronary artery dissection. N Engl J Med 1994; 330:510-11.
Choi YS, Pearl WR. Cardiovascular effects of adolescent drug abuse. J Adolesc Drug Abuse 1989; 10:332-7.
Milroy CM, Clark JC, Forrest ARW. Pathology of deaths associated with “ecstasy” and “eve” misuse. J Clin Pathol 1996; 49:149-53.
Albertson T, Walby W, Derlet R. Stimulant induced pulmonary toxicity. Chest 1995; 198:1140-9.
Weiner R, Lockhart JT, Schwartz RG. Dilated cardiomyopathy and cocaine abuse: report of two cases. Am J Med 1986; 81:699-701.
Hill SL, Thomas SH. Clinical toxicology of newer recreational drugs. Clin Toxicol (Phila) 2011; 49(8):705-19.
Muñoz H, Vargas A. Síndrome serotoninérgico. MedUNAB 2004; 7(20):144-150.
González FJ, Meyer UA. Molecular genetics of the debrisoquin-sparteine polymorphism. Clin. Pharmacol. Ther 1991; 50(3):233-238.
Pardo-Lozano R, Farré M, Yubero-Lahoz S, O’Mathúna B, Torrens M, Mustata C, et al. Clinical pharmacology of 3,4-methylenedioxymethamphetamine (MDMA, “ecstasy”): the influence of gender and genetics (CYP2D6, COMT, 5-HTT). PLoS One 2012; 7(10):e47599.
Lenton S, Boys A, Norcross K. Raves, drugs and experience: drug use by a sample of people who attend raves in Western Australia. Addiction 1997; 92:1327-37.
Jansen KL. A review of the nonmedical use of ketamine: use, users and consequences. J Psychoactive Drugs 2000; 32:419-33.
Weir E. Raves: A review of the culture, the drugs and the prevention of harm. CMAJ 2000; 162:1843-8.
Abanades S, Farre M. Drogas de diseño. Med Clin (Barc) 2003; 121:38.
Riley SC, James C, Gregory D, Dingle H, Cadger M. Patterns of recreational drug use at dance events in Edinburgh, Scotland. Addiction 2001; 96:1035-47.
Winstock AR, Griffiths P, Stewart D. Drugs and the dance music scene: a survey of current drug use patterns among a sample of dance music enthusiasts in the UK. Drug Alcohol Depend 2001; 64:9-17.
Tossmann P, Boldt S, Tensil MD. The use of drugs within the techno party scene in European metropolitan cities. Eur Addict Res 2001; 7:2-23.
Vivas NM, Màrmol F, Sallés J, Badia A, Dierssen M. Action on noradrenergic transmission of an anticholinesterase: 9-amino-1,2,3,4-tetrahydroacridine. Neuropharmacology 1995; 34(4):367-75.
Benedict RG, Tyler VE. Blueing in Conocybe, Psilocybe, and a Stropharia species and the detection of psilocybin. Lloydia 1967; 30:149-157.
Bogusz MJ, Maier RD, Schafer AT, Erkens M. Honey with Psilocybe mushrooms: a revival of a very old preparation on the drug market? Int. J. Legal Med 1998; 111:147-150.
Kulkarni SV, Mughani YA, Onbol EH, Kempegowda P. Khat and stroke. Ann Indian Acad Neurol 2012; 15(2):139-40.
Lurie Y, Gopher A, Lavon O, Almog S, Sulimani L, Bentur Y. Severe paramethoxymethamphetamine (PMMA) and paramethoxyamphetamine (PMA) outbreak in Israel. Clin Toxicol (Phila) 2012; 50(1):39-43.
Loor R, Lingenfelter C, Wason PP, Tang K, Davoudzadeh D. Multiplex assay of amphetamine, methamphetamine, and ecstasy drug using CEDIA technology. J Anal Toxicol 2002; 26(5):267-73.
Staack RF, Maurer HH. Metabolism of designer drugs of abuse. Curr Drug Metab 2005; 6(3):259-74.
Beck O, Villén T. Drugs of abuse testing safer and safer and more complete. Lakartidningen 2011; 108(45):2300-3.
Huerta-Fontela M, Pineda O, Ventura F, Galceran MT. New chlorinated amphetamine-type-stimulants disinfection-by-products formed during drinking water treatment. Water Res 2012; 46(10):3304-14.
Albertson T, Walby W, Derlet R. Stimulant-induced pulmonary toxicity. Chest 1995; 108:1140-9.
Mendelson J, Jones RT, Upton R, et al. Methamphetamine and ethanol interaction in man. Clin Pharmacol Ther 1995; 57:559-68.
Kalant H. The pharmacology and toxicology of “ecstasy” (MDMA) andrelated drugs. Can Med Assoc J 2001; 165:917-928.
De Boer D, Bosman IJ, Hidvegi E, et al. Piperazine-like compounds: a newgroup of designer drugsof-abuse on the European market. Forensic SciInt 2001; 121:47-56.
Staack RF, Fritschi G, Maurer HH. Studies on the metabolism and the toxicological analysis of the new piperazine-like designer drug Nbenzylpiperazine in urine using gas chromatography-mass spectrometry. J Chromatogr B 2002; 773:35-46.
Staack RF, Fritschi G, Maurer HH. New designer drug 1-(3-trifluoromethylphenyl) piperazine (TFMPP): gas chromatography/mass spectrometry and liquid chromatography/mass spectrometry studies on its phase I and II metabolism and on its toxicological detection in rat urine. J Mass Spectrom 2003; 38:971-981.
Rotzinger S, Fang J, Coutts RT, et al. Human CYP2D6 and metabolism of m chlorophenylpiperazine. Biol Psychiatry 1998; 44:1185-1191.
Staack RF, Paul LD, Springer D, et al. Cytochrome P450 dependent metabolism of the new designer drug 1-(3-trifluoromethylphenyl) piperazine (TFMPP). In vivo studies in Wistar and Dark Agouti rats as well as in vitro studies in human liver microsomes. Biochem Pharmacol 2004; 67:235-244.
Maurer HH, Kraemer T, Springer D, Staack RF. Chemistry, pharmacology, toxicology and hepatic metabolism of designer drugs of the amphetamine (ecstasy), piperazine and pyrrolidinophenone types: a synopsis. Ther Drug Monit 2004; 26(2):127-31.
Springer D, Peters FT, Fritschi G, et al. Studies on the metabolism and toxicological detection of the new designer drug 4_-methyl alphapyrrolidinopropiophenone in urine using gas chromatographymass spectrometry. J Chromatogr B 2002; 773:25-33.
Springer D, Fritschi G, Maurer HH. Metabolism and toxicological detection of the new designer drug 3_,4_-methylenedioxy-alphapyrrolidinopropiophenone studied in urine using gas chromatographymass spectrometry. J Chromatogr B 2003; 793:377-388.
Springer D, Fritschi G, Maurer HH. Metabolism and toxicological detection of the new designer drug 4-methoxy-pyrrolidinopropiophenone studied in rat urine using gas chromatography-mass spectrometry. J Chromatogr B 2003; 793:331-342.
Ricca V, Castellini G, Mannucci E, et al. Amphetamine derivatives and obesity. Appetite 2009; 52(2):405-9.
Freo U. Cerebral metabolic effects of serotonin drugs and neurotoxins. Life Sci 1996; 59:877-891.
Marek GJ, Aghajanian GK. LSD and the phenethylamine hallucinogen DOI are potent partial agonists at 5-HT2A receptors on interneurons in rat piriform cortex. J Pharmacol Exp Ther 1996; 278(3):1373-82.
Franz X. Vollenweidera U, Ralph P, et al. Effects of high amphetamine dose on mood and cerebral glucose metabolism in normal volunteers using positron emission tomography. Psychiatry Res Neuroimag 1998: 83(3):149-162.
Griffith JD, Cavanaugh J, Held J, Oates JA. Dextroamphetamine. Evaluation of psychomimetic properties in man. Archives of General Psychiatry 1972; 26:97-100.
Silverstone T, Wells B, Trenchart E. Differential dose-response effects of dexamphetamine sulphate on hunger and mood in human volunteers. Psychopharmacology 1983; 79:242-45.
Hall W, Hando J, Darke S, Ross J. Psychological morbidity and route of administration among amphetamine users in Australia. Addiction 1996; 91:81-7.
Mouhaffet A, Madu E, Satmary W, et al. Cardiovascular complications of cocaine. Chest 1995; 107:1426-34.
Henry JA, Jeffreys KJ, Dawling S. Toxicity and death from 3,4 methylenedioxymethamphetamine (“ectasy”). Lancet 1992; 340:384-7.
Smit A, Wieling W, Voogel A, et al. Orthostatic hypotension due to suppression of vasomotor flow after amphetamine intoxication. Mayo Clin Proc 1996; 71:1067-70.
Mittleman MA, Mintzer D, Maclure M. Triggering of myocardial infarction by cocaine. Circulation 1999; 99:2737-41.
Bashour T. Acute myocardial infarction resulting from amphetamine abuse: spasm thrombus interplay? Am Heart J 1994; 128:1237-8.
Joffe BD, Broderick TM, Leier CV. Cocaine induced coronary artery dissection. N Engl J Med 1994; 330:510-11.
Choi YS, Pearl WR. Cardiovascular effects of adolescent drug abuse. J Adolesc Drug Abuse 1989; 10:332-7.
Milroy CM, Clark JC, Forrest ARW. Pathology of deaths associated with “ecstasy” and “eve” misuse. J Clin Pathol 1996; 49:149-53.
Albertson T, Walby W, Derlet R. Stimulant induced pulmonary toxicity. Chest 1995; 198:1140-9.
Weiner R, Lockhart JT, Schwartz RG. Dilated cardiomyopathy and cocaine abuse: report of two cases. Am J Med 1986; 81:699-701.
Hill SL, Thomas SH. Clinical toxicology of newer recreational drugs. Clin Toxicol (Phila) 2011; 49(8):705-19.
Muñoz H, Vargas A. Síndrome serotoninérgico. MedUNAB 2004; 7(20):144-150.
González FJ, Meyer UA. Molecular genetics of the debrisoquin-sparteine polymorphism. Clin. Pharmacol. Ther 1991; 50(3):233-238.
Pardo-Lozano R, Farré M, Yubero-Lahoz S, O’Mathúna B, Torrens M, Mustata C, et al. Clinical pharmacology of 3,4-methylenedioxymethamphetamine (MDMA, “ecstasy”): the influence of gender and genetics (CYP2D6, COMT, 5-HTT). PLoS One 2012; 7(10):e47599.
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