Prognostic value of lipid peroxidation changes in acute poisoning with household drugs “bath salts”

Abstract

Aim. To study the state of lipid peroxidation processes in case of psychodisleptic poisoning of the “bath salt” type and to determine the clinical and biochemical markers of a favorable and complicated course of the acute period of poisoning.

Methods. In 347 patients with acute household poisoning (“bath salts”) admitted to the toxicology department of the Chelyabinsk Regional Clinical Hospital №3, the clinical and biochemical features of the acute period of psychodisleptic poisoning (“bath salts”) were studied in a favorable and unfavorable course. Blood and urine samples were taken from all patients, which later underwent chemical and toxicological studies by gas chromatography-mass spectrometry. Also, lipid peroxidation and antioxidant activity were determined in selected blood samples. Lipid peroxidation products were detected in heptane-isopropanol extracts of biological material by spectrophotometry. The intensity of Fe2+-ascorbate-induced lipid peroxidation was determined in E.I. L'vovskaya's modification. The study of patients' samples was carried out in the biochemical laboratory of the regional clinical hospital №3, at the Department of Biochemistry of the Ural state university of physical culture and the South Ural state medical university of Chelyabinsk.

Results. Patients with “bath salts” poisoning in the acute period showed an elevated content of all categories of peroxidation products in the blood serum — by 1.51–1.70 times more than in the control group of healthy people. A decrease in antioxidant activity values I and II by 1.13–1.31 times was also found. With favorable outcomes of poisoning, the level of activation of lipid peroxidation processes decreased with an adequate increase in the activity of the antioxidant system by 1.5–1.6 times. The activation of lipid peroxidation processes in the blood serum accompanied by a decrease in the activity of antioxidant system led to an unfavorable course of the disease and the development of cerebral edema in 18 patients which was fatal.

Conclusion. The clinical and biochemical features of the course of the acute period of poisoning with “bath salts” revealed by us suggest adverse outcomes of the disease with a tendency to an increase in the content of serum lipid peroxidation products in the course of the disease (instead of reducing them) along with a reduction of antioxidant activity; these indicators should be compensated by the use of antioxidant therapy.

Keywords

psychodisleptic / “bath salts” / narcotic drugs / prognosis / lipid peroxidation / antioxidant system / cerebral edema

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Sumnaya D.B., Iksanov A.V., Shkarednykh V.Y., Sadova V.A., Kuleshova M.V.