title: Clinical characteristics of α-pyrrolidinovalerophenone (α-PVP) poisoning.
abstract: BACKGROUND
  α-Pyrrolidinovalerophenone (α-PVP) is a synthetic cathinone that has been abused in recent years. The clinical presentation of acute α-PVP poisoning has not been well characterized.
  
  
  OBJECTIVE
  To elucidate the clinical features of acute α-PVP poisoning.
  
  
  METHODS
  This retrospective case series included eight subjects that visited our hospital emergency department (ED) between March 2012 and November 2014 and had analytically confirmed blood α-PVP levels. Data related to subject demographics, clinical history, laboratory findings, blood drug levels, and outcome were collected.
  
  
  RESULTS
  The median age of the eight study subjects was 27 (range; 21-63) years, and six were male. Drug preparations had been administered by rectal insertion (three subjects) or inhalation (five subjects). The time between drug exposure and presentation at the ED was 8.5 (1-24) h and blood α-PVP concentrations ranged from 1.0 to 52.5 ng/ml. Although psychiatric and neurological findings were reported before arrival at the ED in 5/8 and 7/8 subjects, respectively, these were only observed in 1/8 and 2/8 subjects, respectively, at the ED. Symptoms of high body temperature (3/8), tachycardia (5/8), hypertension (3/8), acid-base balance disorder (5/8), coagulopathy (4/6), blood creatinine phosphokinase >190 U/l (6/8), and a blood lactate level > 1.7 mmol/l (5/7) were observed. All subjects survived and were discharged.
  
  
  CONCLUSIONS
  This retrospective case series showed that after acute exposure to α-PVP, transient neuropsychiatric findings were accompanied by more persistent sympathomimetic physical findings, disorders of acid-base balance and blood coagulation, high blood creatinine phosphokinase, and hyperlactacidemia.
authors.affiliation: a Department of Emergency and Critical Care Medicine , Tokai University School of Medicine , Kanagawa , Japan.
authors.forename: Rimako
authors.initials: R
authors.lastname: Umebachi
authors.affiliation: a Department of Emergency and Critical Care Medicine , Tokai University School of Medicine , Kanagawa , Japan.
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Aoki
authors.affiliation: a Department of Emergency and Critical Care Medicine , Tokai University School of Medicine , Kanagawa , Japan.
authors.forename: Mariko
authors.initials: M
authors.lastname: Sugita
authors.affiliation: a Department of Emergency and Critical Care Medicine , Tokai University School of Medicine , Kanagawa , Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Taira
authors.affiliation: a Department of Emergency and Critical Care Medicine , Tokai University School of Medicine , Kanagawa , Japan.
authors.forename: Shinjirou
authors.initials: S
authors.lastname: Wakai
authors.affiliation: a Department of Emergency and Critical Care Medicine , Tokai University School of Medicine , Kanagawa , Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Saito
authors.affiliation: a Department of Emergency and Critical Care Medicine , Tokai University School of Medicine , Kanagawa , Japan.
authors.forename: Sadaki
authors.initials: S
authors.lastname: Inokuchi
mesh_terms: D000136:Acid-Base Equilibrium; D000328:Adult; D001777:Blood Coagulation / Q000187:drug effects; D003402:Creatine Kinase / Q000097:blood; D005260:Female; D006801:Humans; D065906:Hyperlactatemia / Q000097:blood; D008297:Male; D008875:Middle Aged; D011759:Pyrrolidines / Q000506:poisoning*; D012189:Retrospective Studies; D015813:Substance Abuse Detection; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000209:etiology; D055815:Young Adult
chemical_list: D011759:Pyrrolidines; C542924:alpha-pyrrolidinovalerophenone; D003402:Creatine Kinase
keywords: LC-MS/MS; new psychoactive substance; synthetic cathinone