[Triage DOA screening in a case of methamphetamine and its analogue poisoning].
METHODS
A 20-year-old woman presented with the chest pain, nausea, respiratory strange feeling, and a large quantity of sweating. On the stimulant zone of 8 groups of drugs of Triage DOA screening it showed an equivocal positivity while all of the other zones gave negative results. She denied taking drugs. No injection scar was found. And she was then hospitalized because little was known about her symptoms. When the unconscious patient was discovered at rest room inside hospital the next day, she was transferred to emergency and critical care center. In the same screening test positivity on the stimulant zone was observed, and furthermore both amphetamine and methamphetamine were detected by GCMS analysis. For 4 days positivity on the stimulant zone lasted. From the fact of disturbance of consciousness, restlessness, excitation and tachycardia, respiration disorder, and the pupil dilatation drug poisoning was deeply suspected.


CONCLUSIONS
While the stimulant zone of Triage DOA showed the equivocal positivity when 7 hours has elapsed until she became aware of abnormality and hospitalized, in the same screening of 30 hours later positivity was verified clearly. Several problems derived from the detection method, pharmacokinetic factors and pharmacodynamic aspect were discussed as for the difference of the results detected.
Center for Medical Care Pharmacy, Meiji Pharmaceutical University.
Shigeru
S
Adachi
Center for Medical Care Pharmacy, Meiji Pharmaceutical University.
Akira
A
Takamura
Division of Pharmacy, Tokyo Medical Center of National Hospital Organization.
Takashi
T
Ebihara
Division of Pharmacy, Tokyo Medical Center of National Hospital Organization.
Yoshihiko
Y
Suzuki
Emergency & Critical Care Center, Tokyo Medical Center of National Hospital Organization.
Takuo
T
Yoshida
Emergency & Critical Care Center, Tokyo Medical Center of National Hospital Organization.
Ryo
R
Suzuki
Emergency & Critical Care Center, Tokyo Medical Center of National Hospital Organization.
Takaaki
T
Kikuno
D000328:Adult; D000661:Amphetamine / Q000097:blood / Q000493:pharmacokinetics / Q000506:poisoning*; D000697:Central Nervous System Stimulants / Q000097:blood / Q000493:pharmacokinetics / Q000506:poisoning*; D005260:Female; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D008694:Methamphetamine / Q000097:blood / Q000493:pharmacokinetics / Q000506:poisoning*; D015813:Substance Abuse Detection / Q000295:instrumentation / Q000379:methods*; D019966:Substance-Related Disorders / Q000175:diagnosis*; D013997:Time Factors; D014218:Triage / Q000379:methods*; D014474:Unconsciousness / Q000139:chemically induced; D055815:Young Adult
D000697:Central Nervous System Stimulants; D008694:Methamphetamine; D000661:Amphetamine