New Psychoactive Substances, New Behaviours, New Drug-drug Interactions: Pharmacology of a Slam Session.

IF 2.1 4区 医学 Q4 BIOCHEMISTRY & MOLECULAR BIOLOGY Current drug metabolism Pub Date : 2023-01-01 DOI:10.2174/1389200224666230228103922
Benoit Schreck, Marion Istvan, Marylène Guerlais, Edouard-Jules Laforgue, Marie Gérardin, Marie Grall-Bronnec, Aurélie Aquizerate, Caroline Victorri-Vigneau
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Abstract

Background: Slamming has been increasing internationally for ten years, mostly among men who have sex with men. Slamming consists of injecting psychostimulants (including new psychoactive substances-NPS) intravenously to increase sexual performance.

Objective: The objective of our work was to analyse drug-drug interactions related to slamming.

Methods: Drawing upon a reported case of a slam session describing hour by hour the intake of substances, we performed a drug-interaction analysis using international references and a comprehensive literature review. High doses of sildenafil, GBL and 3-MMC were reported during the 40-hour session described. The specific drug-interaction research was performed using 9 references and 65 of the 209 records identified in the literature review.

Results: Pharmacological data regarding nonmedicated substances were scarce. Regarding pharmacodynamics, the risk was high at the cardiovascular level and was related to the vasodilatation effect of sildenafil and the adrenergic and serotoninergic properties of stimulants; this risk may increase with usual treatment (involving other vasodilators or central depressants). Regarding pharmacokinetics, the major interactions concerned metabolism by CYP3A4 and CYP2C9, leading to interactions, particularly with HIV medication.

Conclusion: This innovative work provides pharmacological information on drugs that are commonly used in slamming, allowing the development of effective medical-management protocols and the provision of risk-reduction counselling.

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新的精神活性物质,新的行为,新的药物-药物相互作用:一个大满贯会议的药理学。
背景:近十年来,国际上的“砰”行为越来越多,主要发生在男男性行为中。猛击包括静脉注射精神兴奋剂(包括新的精神活性物质- nps)来提高性能力。目的:分析与药物相互作用相关的药物-药物相互作用。方法:根据一个报告的病例,描述了每小时的物质摄入,我们使用国际参考文献和全面的文献综述进行了药物相互作用分析。高剂量的西地那非、GBL和3-MMC在40小时的疗程中被报道。具体的药物相互作用研究使用9篇参考文献和209条记录中的65条进行。结果:有关非药物的药理资料很少。在药效学方面,心血管水平的风险较高,与西地那非的血管扩张作用以及兴奋剂的肾上腺素能和血清素能特性有关;常规治疗(包括其他血管扩张剂或中枢抑制剂)可能会增加这种风险。在药代动力学方面,主要的相互作用涉及CYP3A4和CYP2C9的代谢,导致相互作用,特别是与HIV药物相互作用。结论:这项创新的工作提供了通常用于殴打的药物的药理学信息,允许开发有效的医疗管理协议和提供降低风险的咨询。
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来源期刊
Current drug metabolism
Current drug metabolism 医学-生化与分子生物学
CiteScore
4.30
自引率
4.30%
发文量
81
审稿时长
4-8 weeks
期刊介绍: Current Drug Metabolism aims to cover all the latest and outstanding developments in drug metabolism, pharmacokinetics, and drug disposition. The journal serves as an international forum for the publication of full-length/mini review, research articles and guest edited issues in drug metabolism. Current Drug Metabolism is an essential journal for academic, clinical, government and pharmaceutical scientists who wish to be kept informed and up-to-date with the most important developments. The journal covers the following general topic areas: pharmaceutics, pharmacokinetics, toxicology, and most importantly drug metabolism. More specifically, in vitro and in vivo drug metabolism of phase I and phase II enzymes or metabolic pathways; drug-drug interactions and enzyme kinetics; pharmacokinetics, pharmacokinetic-pharmacodynamic modeling, and toxicokinetics; interspecies differences in metabolism or pharmacokinetics, species scaling and extrapolations; drug transporters; target organ toxicity and interindividual variability in drug exposure-response; extrahepatic metabolism; bioactivation, reactive metabolites, and developments for the identification of drug metabolites. Preclinical and clinical reviews describing the drug metabolism and pharmacokinetics of marketed drugs or drug classes.
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