FORENSIC TOXICOLOGY - Bio Medical Forensics

K8 Purity of Street Ketamine Preparations
Retrieved From Night Club Amnesty Bins
in London
John Ramsey, MSc, TIC TAC Communications Ltd., St. Georges
University of London, Cramner Terrace, London, SW17 0RE, UNITED
KINGDOM; and Michael D. Osselton, and Eva M. Reichardt, MSc*,
Bournemouth University, Talbot Campus, Fern Barrow, Poole, BH12
5BB, UNITED KINGDOM
The goals of this presentation are to describe the analysis of street
ketamine in order to determine the purity of samples commonly
available and to identify what impurities might be present.
This presentation will impact the forensic science community by
showing how the majority of street ketamine samples analyzed were of
high percentage purity suggesting that ketamine may be responsible for
effects on the urogenital system. This also supports the observation that
a number of patients undergoing clinical therapy with ketamine have
reported similar symptoms.
Introduction: Ketamine has been widely used in medicine and
veterinary practice for its anesthetic and analgesic properties linked with
minimal respiratory depression. More recently the drug has gained
popularity as a recreational substance amongst young people. Street
prices of the drug vary between £10 and £20 per gram in the UK. The
UK club magazine Mixmag survey of its readers in 2009 shows 51%
used ketamine in last year, 32% in last month and 18% use it weekly.
30% experienced stomach pains after taking ketamine and 20%
experienced urinary tract problems (more in women). A number of
reports have appeared in the medical literature suggesting a possible link
between ketamine misuse and kidney and bladder disorders. The
pathological cause of the bladder related problems is at present unknown
and it is uncertain whether they are attributable to ketamine or to
impurities that may be present in street preparations. Little information
is available concerning the purity of street ketamine hence analysis was
undertaken on street preparations of the drug retrieved from amnesty
bins in London night clubs. In this paper, the analysis of street ketamine
is described to determine the purity of samples commonly available and
to identify what impurities might be present.
Method: Street ketamine samples were analyzed using HPLC with
diode-array in order to determine the percentage of ketamine present in
the sample and identify any impurities. The system was equipped with
a C 18 reversed phase column which was maintained at 50°C. The
mobile phase was a mixture of 5 mM SDS in 20 mM
KH 2 PO 4 :acetonitrile (65:35, v:v) at a flow rate of 1.0 mL/min. In
addition to HPLC analysis, samples were also analyzed using electron
microscopy, color tests, FTIR with golden gate, GC-MS and TLC in an
attempt to determine the nature of any impurities present.
Results: The purity of samples containing Ketamine only ranged
between 65%—100% (mean = 87.9%; SD = 11.66%). Benzocaine was
the principal impurity detected and ranged between 2.75%—16.60%
(mean = of 7.27%; SD = 3.96%). Ketamine in samples containing
Benzocaine ranged between 49.9% - 84% (mean = 67.21%;
SD = 9.71%).
Conclusion: The majority of street ketamine samples were of high
percentage purity suggesting that ketamine may be responsible for
effects on the urogenital system. This also supports the observation that
a number of patients undergoing clinical therapy with ketamine have
reported similar symptoms.
Ketamine use is increasing rapidly worldwide and knowledge
concerning the availability, purity, and trends in drug use can be of
assistance to drug enforcement/legislation agencies as well as healthcare
workers who may be involved in the provision of care to individuals
following drug use. The results of this survey would support a
hypothesis that bladder related diseases observed in ketamine users is
likely to be attributable to ketamine rather than impurities or
cutting agents.
Ketamine, Purity, Bladder Disorders
K9 Confirmation of Oleander Poisoning
by LC/MS
Beril Anilanmert, PhD, Istanbul University, Institute of Forensic Sciences,
Istanbul, 34303, TURKEY; Musa Balta, MD, Istanbul University,
Cerrahpasa Medical Faculty, Internal Emergency Department, Istanbul,
34303, TURKEY; Muhammed Aydin, BSc, Istanbul University, Institute of
Forensic Sciences, Istanbul, 34303, TURKEY; Isil Bavunoglu, MD,
Istanbul University, Cerrahpasa Faculty of Medicine, Internal Emergency
Department, Istanbul, 34303, TURKEY; Salih Cengiz, PhD*, Istanbul
University, Institute of Forensic Sciences, Istanbul, 34300, TURKEY; and
Zeynep Turkmen, MS, Istanbul University, Institute of Forensic Sciences,
Cerrahpasa, Istanbul, 34303, TURKEY
After attending this presentation, attendees will understand how to
confirm oleander poisoning cases from blood and urine specimens.
This presentation will impact the forensic science community by
providing the toxicological data necessary to make diagnostic decision
about the patient when oleandrin is detected by toxicological screening.
In this case a 60-year-old woman was brought to emergency room
with initial symptoms of vomiting, diarrhea, and abdominal pain. The
patient’s heart beat was normal at the beginning but then sinus
bradycardia was observed gradually. Information obtained from her
indicated that she is a cancer patient and that she drank the juice of some
leaves of the oleander plant (Nerium oleander L. - Apocynaceae) for
herbal self treatment. Nerium oleander L. is a member of Apocynaceae
family. Leaves from Nerium oleander were shown to contain 0.018 to
0.425% oleandrin (weight/wet weight). Oleander extracts have been
used for the treatment of indigestion, malaria, leprosy, mental or venereal
diseases but the unconscious usage may cause toxicity.
Blood and urine sample on admission was assayed for oleandrin,
the major cardiac glycoside of N. oleander, which has a wide
geographical range and ecological distribution throughout the world and
also in Turkey. Both specimens were extracted with ethylacetate: nheptan
(1:1) solvent mixture at 9.5 pH. Additionally, some parts of the
oleander plant such as one flower, two leaves and one bark were chosen
for extraction. These parts were cut and crushed in a 50 mL flacon to
obtain about 2 mL sticky juice and then this was diluted with 3 mL water
and extracted with the same solvent mixture.
All separated specimens were performed on a highly specific LC-
MS procedure with gradient elution. Using this analytical setting, the
average retention time for oleandrin was 0.9 min. The major ions
monitored for oleandrin were m/z 577 and 433 indicating total molecular
weight and without glycosides form, respectively. The highest
sensitivity for this assay was obtained with 70 eV.
Qualitative results of the blood and urine samples on admission were
compared with the plant extracts. Also qualitative result of the blood
sample with urine sample was compared with each other. The most
important thing was that the patient recovered without using any digoxin
antibody such as Digifab or Digibind.
This procedure provided the toxicological data necessary to make
diagnostic decisions about the patient when oleandrin was detected by
toxicological screening. Also LC-MS appears to be the method of choice
for the forensic-toxicological investigation of poisonings by cardiac
glycosides.
Oleandrin, Poisoning, LC/MS
5 * Presenting Author