Romanian Society of Pharmaceutical Sciences
 

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ANALYTIC TOXICOLOGICAL STUDY IN POLYDRUG USERS

ADINA-CRISTINA SANDU 1#, GABRIELA VIORELA NIȚESCU 2,3*, NICULAE IORDACHE 3,4,5#, IRINA NISTOR 6, CLAUDIA MARIA GUȚU 1, IULIAN SÂRBU 1, ANNE-MARIE CIOBANU 1, DANIELA LUIZA BACONI ¹

¹ “Carol Davila” University of Medicine and Pharmacy, Faculty of Pharmacy, 6 Traian Vuia Street, 020945, Bucharest, Romania
2 “Grigore Alexandrescu” Emergency Clinical Hospital for Children, Paediatric Clinic 2, Ward ATI -Toxicology, 30-32 Iancu de Hunedoara Boulevard, 011743, Bucharest, Romania
3 “Carol Davila” University of Medicine and Pharmacy, Faculty of Dental Medicine, 15 Olteniței Road, 041292, Bucharest, Romania
4 “Sf. Ioan” Emergency Clinical Hospital, General Surgery Department, 13 Vitan-Bârzești Road, 042122, Bucharest, Romania
5 The Academy of Romanian Scientists, 3 Ilfov Street, 050044, Bucharest, Romania
6 “Grigore Alexandrescu” Emergency Clinical Hospital for Children, Hospital Laboratory, 30-32 Iancu de Hunedoara Boulevard, 011743, Bucharest, Romania

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Drug abuse and addiction are major public health challenges, increasingly complicated by the emergence of new psychoactive substances (NPS) among adolescents. This study characterized the demographic, clinical, and toxicological profiles of 17 adolescents (mean age 16.0 ± 1.22 years; 82.4% male) presented to the emergency department for acute voluntary drug intoxication and compared the exposure history, biochemical, multidrug immunoassay, and qualitative GC-MS findings on urine and plasma samples. Although no classical toxidrome was established, common manifestations included loss of consciousness (58.8%), vomiting (52.9%), and drowsiness (41.2%), with dehydration prominent in self-reported NPS exposure. GC-MS qualitative analysis identified classical drugs of abuse, such as MDMA, ketamine, and its metabolites, as well as mass spectra matching NPS, including a cathinone-type compound. In this patient series, matrix comparison indicated that urine offered superior detection capabilities over plasma, owing to prolonged detection windows and the identification of excreted metabolites. Overall, analytical toxicology provides valuable qualitative support for clinical assessments. Despite the small group limiting statistical generalizations, integrating clinical manifestations with qualitative GC-MS identification remains essential for optimizing emergency care in adolescent drug intoxications.