• Susanna Vogliardi, Giulia Stocchero, Sergio Maietti, Marianna Tucci, Alessandro Nalesso, Rossella Snenghi, and Donata Favretto.
• Department of Cardiological, Thoracic and Vascular Sciences, Legal Medicine and Toxicology, University Hospital of Padova, Via Falloppio 50, I-35121 Padova, Italy.
• Curr Pharm Biotechnol. 2018 Jan 1; 19 (2): 180-187.

Background/ObjectiveWe report on a case of severe intoxication after insufflation of U-47700, a synthetic opioid that acts as a selective agonist of the μ-opioid receptor, and is several times more potent than morphine. A man in his 30s was found irresponsive in his apartment and was brought to the emergency department of a local hospital. A comatose state and severe respiratory depression were present. Hetero anamnesis revealed that the patient could have taken the substance named "U-47700", bought on the Internet. After supportive care, the patient fully recovered.MethodUrine, blood and a white powder found at his home were collected during his hospital stay and sent for testing using liquid chromatography-high resolution mass spectrometry (LC-HRMS) on an Orbitrap instrument. Later, his pubic hair was also collected. A standard comprehensive toxicology screening was performed.ResultsU-47700 was identified in all biological samples and in the seized white powder. Using liquid chromatography-high resolution mass spectrometry (LC-HRMS) the presence of U-47700 and its phase I and phase II metabolites in blood, urine and pubic hair was confirmed. U-47700 was determined at 94 ng/mL and 5.2 ng/mL in blood at the admission and the day after, respectively, and 3.02 ng/mg in pubic hair, together with its metabolites. No other opioid nor designer drug could be detected in blood and urine, while in pubic hair Cocaine, Benzoylecgonine, Norcocaine, Mephedrone, Ketamine, Norketamine, 3,4-Methylenedioxymethamphetamine, Tetrahydrocannabinol and Cannabinol were also detected.ConclusionThe toxicological findings confirmed the use of U-47700 in the intoxicated patient and also revealed a history of a poly-drug use. The use of LC-HRMS allowed the easy identification of the NPS and its metabolites in fluids and hair.Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

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