Abstract
Reports of abuse of designer stimulant drug, frequently sold as ‘bath salts’ or ‘plant nutrition’, have increased dramatically in recent years, particularly among young people. We report a case of 30-year-old male who had taken a designer stimulant drug and subsequently lost consciousness on the next day. He was tracheally intubated after convulsion in the emergency room. He developed autonomic ataxia, hyponatremia, acidemia, and rhabdomyolysis. The titer of creatinine kinase (CK), aspartate aminotransferase (AST), and lactate dehydrogenase (LDH) were increased to 70,842U/l, 939U/l, 1,051U/l, respectively, but improved after fluid resuscitation without renal failure. Gas chromatography - mass spectrometry (GC/MS) was used to detect the components of the drug. The major component was pyrovalerone, intake of which was proven in blood, urine and stomach contents using GC/MS; its concentration was 1.73μg/ml in the blood, 41.9μg/ml in the urine on day 1 and 0.001μg/ml in the blood, 0.108μg/ml in the urine on day 9. The patient was discharged from the hospital without any symptoms. Access to various designer stimulant drug is easy, fast and broad. Clinicians need to be especially vigilant in that overdoses of designer stimulant drug can be life-threatening, hence detailed analyses of the drugs are desirable.
