Methaqualone, known previously under the brand name Quaalude, is a Schedule I sedative hypnotic drug that may cause neurotoxicity in overdose, characterized by somnolence, hyperreflexia and muscular hyperactivity. We present a case of a 21-year-old male who reportedly ingested methaqualone in addition to insufflation of street cocaine. He subsequently developed hypoxia, hyperreflexia, myoclonus and altered mental status. His laboratory results were notable for the presence of methemoglobinemia, which was most likely due to a cocaine contaminant. Laboratory analysis of the alleged methaqualone pills identified the substance as SL-164, a dichlorinated methaqualone analog. Urine toxicology results were positive for SL-164 (and presumed metabolites) as well as for cocaine and tetrahydrocannabinol metabolites. The patient was treated with supplemental oxygen and a benzodiazepine (lorazepam) and observed in the Emergency Department until his symptoms resolved. This case highlights current community access to methaqualone analogs. The case also focuses on laboratory techniques used to identify the methaqualone analog.

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暗指过去：甲喹酮类药物摄入案例

甲喹酮，以前以 Quaalude 品牌而闻名，是一种附表 I 镇静催眠药物，过量服用可能会导致神经毒性，其特征是嗜睡、反射亢进和肌肉过度活跃。我们介绍了一个 21 岁男性的案例，据报道他除了吸入街头可卡因外还摄入了甲喹酮。随后，他出现缺氧、反射亢进、肌阵挛和精神状态改变。他的实验室结果因存在高铁血红蛋白血症而引人注目，这很可能是由于可卡因污染物造成的。对所谓的甲喹酮药丸的实验室分析确定该物质为 SL-164，一种二氯甲喹酮类似物。SL-164（和推测的代谢物）以及可卡因和四氢大麻酚代谢物的尿液毒理学结果呈阳性。患者接受了补充氧气和苯二氮卓类药物（劳拉西泮）的治疗，并在急诊科观察直至症状消失。这个案例突出了当前社区对甲喹酮类似物的获取。该案例还侧重于用于鉴定甲喹酮类似物的实验室技术。