25C-NBOMe: Difference between revisions

(Created page with "==Background== *2-(4-chloro-2,5-dimethoxyphenyl)-N-[(2-methoxyphenyl)methyl]ethanamine *Other names: NBOMe-2C-C, Boom, C-Boom, Cimbi-82, Pandora, N-bomb, Holland film, Dime *P...")
 
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''Although this article specifically addresses 25C-NBOMe, there are also 25I- and 25B- versions of the compound''
==Background==
==Background==
[[File:25C-NBOMe.png|thumb|25C-NBOMe]]
[[File:25C-NBOMe blotter.jpg|thumb|Blotter paper containing 25C-NBOMe]]
*2-(4-chloro-2,5-dimethoxyphenyl)-N-[(2-methoxyphenyl)methyl]ethanamine
*2-(4-chloro-2,5-dimethoxyphenyl)-N-[(2-methoxyphenyl)methyl]ethanamine
*Other names: NBOMe-2C-C, Boom, C-Boom, Cimbi-82, Pandora, N-bomb, Holland film, Dime
*Other names: NBOMe-2C-C, Boom, C-Boom, Cimbi-82, Pandora, N-bomb, Holland film, Dime
*Potent partial agonist of 5-HT2A receptor
*Potent partial agonist of 5-HT2A receptor<ref name="pharm">Bersani FS, Corazza O, Albano G, et al. 25C-NBOMe: preliminary data on pharmacology, psychoactive effects, and toxicity of a new potent and dangerous hallucinogenic drug. Biomed Res Int. 2014;2014:734749.</ref>
*Member of new class of toxic phenethylamine derivatives (NBOMe)
*First synthesized in Germany by Ralf Heim in 2004<ref>Heim R. “Synthese und Pharmakologie potenter 5-HT2A-Rezeptoragonisten mit N-2-Methoxybenzyl-Partialstruktur”. :Entwicklung eines neuen Struktur-Wirkungskonzepts. Berlin, Freie University, Dissertation, 2003</ref>
*Commonly ingested orally or sublingually; can also be ingested nasally, parenterally, vaginally, rectally  
*Member of new class of toxic phenethylamine derivatives (NBOMe) with similar effects to [[LSD]]
*Dose of 50-200 micrograms causes hallucinogenic effects
*Commonly ingested orally or sublingually; can also be taken nasally, parenterally, vaginally, rectally.
*Onset 0-15 mins, peak 30-90 mins, total duration 4-10 hours
*Dose of 50-200 micrograms causes hallucinogenic effects<ref name="pharm"></ref>
*Onset 0-15 mins, peak 30-90 mins, total duration 4-10 hours<ref name="pharm"></ref>
*Case reports of ingestions have included overdose symptoms of grand mal seizures and purpuric rash and mydriasis with 25'''B'''-NBOMe variant<ref>Poklis JL. et al. Determination of 4 bromo 2,5 dimethoxy N [2 methoxyphenyl) methyl] benzeneethanamine (25B-NBOMe) in serum and urine by high performance liquid chromatography with tandem mass spectrometry in a case of severe intoxication. Drug Test Anal. 2004;6:764-9</ref>
*The 25I- version of the drug has symptoms described as tachycardia, hallucinations, hypertension, and seizures and agitation.<ref>Poklis J. Devers KG et al. Postmortem detection of 25I-NBOMe [2-(4-iodo-2,5-dimethoxyphenyl)methyl] ethanamine] in fluids and tissues determined by high performance liquid chromatography with tandem mass spectrometry from a traumatic death. Forensic Sci Int. 2014;234:e14-e20</ref>


==Clinical Features==
==Clinical Features==
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*Sense of numbness of tongue and mouth
*Sense of numbness of tongue and mouth
*Euphoria
*Euphoria
*Visual/Auditory hallucinations
*Visual/Auditory [[hallucinations]]
*Stimulation +/- tremors, bruxism
*Stimulation +/- tremors, bruxism
*Serotonin syndrome (AMS, hyperthermia, rigidity, autonomic instability)
*[[Serotonin Syndrome]] ([[altered mental status]], [[Hyperthermia]], rigidity, autonomic instability)<ref>Boyer EW, Shannon M. The serotonin syndrome. NEJM. 2005;352:1112-20</ref>
*Confusion
*Confusion
*Agitation
*Agitation
*Vasoconstriction
*Vasoconstriction
*Nausea/Vomiting
*[[Nausea and Vomiting]]
*Headache
*[[Headache]]
*Palpitations
*Palpitations
*Diaphoresis  
*Diaphoresis  
*Dysuria
*[[Dysuria]]
*Hypertension
*Hypertension
*Generalized seizure
*Generalized [[Seizure]]
*Mydriasis
*Mydriasis
*Acute renal failure
*[[Acute Renal Failure]]
*Metabolic acidosis
*[[Metabolic Acidosis]]


==Workup==
==Differential Diagnosis==
*ISTAT
{{Drugs of abuse types}}
*Urine pregnancy
{{Hallucinogen types}}
*CBC, BMP, LFTs, coags, APAP, ASA
*CK
*ECG
*UA
*Tox screen, blood alcohol
*Serum osmoles, urine Na (if hyponatremia present)
*Head CT as indicated
*LP as indicated to rule out meningitis


==Treatment==
==Evaluation==
{{Hallucinogen workup}}
 
==Management==
*ABCs
*ABCs
*IV, O2, monitor
*IV, O2, monitor
*Agitation
*'''Agitation'''
**benzos
**[[Benzodiazepines]]
**haldol
**[[Haldol]] for acute agitation
*Seizure:
*'''[[Seizure]]'''
**benzos
**[[Benzodiazepines]]
**manage airway as indicated
*[[Hyperthermia]]:
*Hyperthermia:
**Passive cooling measures
**ice packs, cold IVF


==Disposition==
==Disposition==
*Admit pt's with complications of ingestion
*Admit for monitoring on all patients with continuing agitation requiring escalating doses of sedation
*Consider discharge if complete resolution of symptoms
 
==See Also==
*[[Lysergic acid diethylamide (LSD)]]
*[[Ecstasy (MDMA) toxicity]]
*[[Hallucinations]]
*[[Hallucinogens]]


==Sources==
==References==
Bersani FS, Corazza O, Albano G, et al. 25C-NBOMe: preliminary data on pharmacology, psychoactive effects, and toxicity of a new potent and dangerous hallucinogenic drug. Biomed Res Int. 2014;2014:734749.
<references/>


[[Category:Tox]]
[[Category:Toxicology]]

Latest revision as of 19:52, 24 April 2024

Although this article specifically addresses 25C-NBOMe, there are also 25I- and 25B- versions of the compound

Background

25C-NBOMe
Blotter paper containing 25C-NBOMe
  • 2-(4-chloro-2,5-dimethoxyphenyl)-N-[(2-methoxyphenyl)methyl]ethanamine
  • Other names: NBOMe-2C-C, Boom, C-Boom, Cimbi-82, Pandora, N-bomb, Holland film, Dime
  • Potent partial agonist of 5-HT2A receptor[1]
  • First synthesized in Germany by Ralf Heim in 2004[2]
  • Member of new class of toxic phenethylamine derivatives (NBOMe) with similar effects to LSD
  • Commonly ingested orally or sublingually; can also be taken nasally, parenterally, vaginally, rectally.
  • Dose of 50-200 micrograms causes hallucinogenic effects[1]
  • Onset 0-15 mins, peak 30-90 mins, total duration 4-10 hours[1]
  • Case reports of ingestions have included overdose symptoms of grand mal seizures and purpuric rash and mydriasis with 25B-NBOMe variant[3]
  • The 25I- version of the drug has symptoms described as tachycardia, hallucinations, hypertension, and seizures and agitation.[4]

Clinical Features

Differential Diagnosis

Drugs of abuse

Hallucinations

Serotonin-Like Agents

Enactogens

Dissociative Agents

Plant-based Hallucinogenics

  • Marijuana
  • Salvia
  • Absinthe
  • Isoxazole Mushrooms
  • Hawaiian baby woodrose (Argyreia nervosa)
  • Hawaiian woodrose (Merremia tuberosa)
  • Morning glory (Ipomoea violacea)
  • Olili- uqui (Rivea corymbosa)

Organic causes

Other Toxicologic Causes

Psychiatric Causes [6]

Evaluation

Hallucination workup

Management

Disposition

  • Admit for monitoring on all patients with continuing agitation requiring escalating doses of sedation
  • Consider discharge if complete resolution of symptoms

See Also

References

  1. ↑ 1.0 1.1 1.2 Bersani FS, Corazza O, Albano G, et al. 25C-NBOMe: preliminary data on pharmacology, psychoactive effects, and toxicity of a new potent and dangerous hallucinogenic drug. Biomed Res Int. 2014;2014:734749.
  2. ↑ Heim R. “Synthese und Pharmakologie potenter 5-HT2A-Rezeptoragonisten mit N-2-Methoxybenzyl-Partialstruktur”. :Entwicklung eines neuen Struktur-Wirkungskonzepts. Berlin, Freie University, Dissertation, 2003
  3. ↑ Poklis JL. et al. Determination of 4 bromo 2,5 dimethoxy N [2 methoxyphenyl) methyl] benzeneethanamine (25B-NBOMe) in serum and urine by high performance liquid chromatography with tandem mass spectrometry in a case of severe intoxication. Drug Test Anal. 2004;6:764-9
  4. ↑ Poklis J. Devers KG et al. Postmortem detection of 25I-NBOMe [2-(4-iodo-2,5-dimethoxyphenyl)methyl] ethanamine] in fluids and tissues determined by high performance liquid chromatography with tandem mass spectrometry from a traumatic death. Forensic Sci Int. 2014;234:e14-e20
  5. ↑ Boyer EW, Shannon M. The serotonin syndrome. NEJM. 2005;352:1112-20
  6. ↑ Visual Hallucinations: Differential Diagnosis and Treatment. PMID PMC2660156
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