Clenbuterol-contaminated heroin: Cardiovascular and metabolic effects: A case series and review

Connecticut Medicine

Volumn 70, Issue 1, 2006, Pages 5-11

  Werder, Gabriel ^a   Arora, Gaurav ^a   Frisch, Anna ^a   Aslam, Sharique ^a   Imani, Farzin ^a   Missri, Jose ^a,b  

^a St Vincent's Medical Center   (United States)

^b St Vincent's Medical Center ^*  (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ACETYLSALICYLIC ACID; ALPHA ADRENERGIC RECEPTOR STIMULATING AGENT; ALPRAZOLAM; BETA ADRENERGIC RECEPTOR BLOCKING AGENT; CALCIUM CHANNEL BLOCKING AGENT; CEFTRIAXONE; CLENBUTEROL; CLOPIDOGREL; COCAINE; DIAMORPHINE; DIAZEPAM; DOPAMINE; ESMOLOL; GLYCERYL TRINITRATE; HEPARIN; HYPERTENSIVE FACTOR; INSULIN; LABETALOL; LISINOPRIL; METHADONE; MORPHINE; NORADRENALIN; OPIATE AGONIST; OXYCODONE; PROCAINE; SALBUTAMOL; SIMVASTATIN; VERAPAMIL;

ADULT; ANXIETY; CARDIOVASCULAR EFFECT; CLINICAL ARTICLE; DRUG ABUSE; DRUG CONTAMINATION; DRUG INTOXICATION; HEADACHE; HEART INFARCTION; HEART PALPITATION; HUMAN; HYPERGLYCEMIA; HYPOKALEMIA; HYPOPHOSPHATEMIA; HYPOTENSION; MALE; METABOLISM; NAUSEA; REVIEW; ST SEGMENT ELEVATION; TACHYCARDIA; THORAX PAIN; TREMOR; VOMITING; WITHDRAWAL SYNDROME;

ADRENERGIC BETA-AGONISTS; ADULT; CARDIOVASCULAR SYSTEM; CLENBUTEROL; DRUG CONTAMINATION; HEROIN; HUMANS; MALE; NARCOTICS; STREET DRUGS;

EID: 30344434671     PISSN: 00106178     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Review

References (30)

1. Contaminated heroin sparks health fears: The Courier, Dundee, Scotland. Jan 20, 2005. Available at: http://www.thecourier.co.uk/output/2005/01/20/ newsstory6735048t0.asp. Accessed: May 3, 2005.
2. Rogue heroin warning to addicts: BBC News, UK Edition. Jan 19, 2005. Available at: http://news.bbc.co.uk/1/hi/scotland/4189093.stm. Accessed: May 3, 2005.
3. Reynolds JEF (ed): Martindale-The Extra Pharmacopeia (electronic version). Micromedex, Inc, Englewood, CO, 1995.
4. Keelan P, Gray P, Cox GA: A multiple-dose response study of clenbuterol in bronchial asthma. Ir Med J 1980 73(10):382-4.
5. Pasotti C, Capra A, Vibelli C: NAB 365 (clenbuterol) and salbutamol in asthmatics: A double-blind clinical trial. Int J Clin Pharmacol Biopharm 1979 17(4):176-80.
6. Wheatley D: Clenbuterol "Spiropent": Along-acting bronchodilator. Curr Med Res Opin 1982; 8(2):113-9.
7. Cummiskey J, Keelan P, Gray P, Cox GA: Comparison of NAB 365 and salbutamol tablets in chronic bronchitis and asthma. Ir Med J 1978; 71(4):123-6.
8. Salleras L, Dominguez A, Mata E, et al: Epidemiologic study of an outbreak of clenbuterol poisoning in Catalonia, Spain. Pub Health Rep 1995; 110(3):338-42.
9. Hoffman RJ, Hoffman RS, Freyberg CL, et al: Clenbuterol ingestion causing prolonged tachycardia, hypokalemia, and hypophosphatemia with confirmation by quantitative levels. J Toxicol Clin Toxicol 2001; 39(4):339-44.
10. Mitchell GA, Dunnavan G: Illegal use of beta-adrenergic agonists in the United States. J Anim Sci 1998; 76(1):208-11.
11. Chan TY: Health hazards due to clenbuterol residues in food. J Toxicol Clin Toxicol 1999; 37(4):517-9.
12. Bilbao Garay J, Hoyo Jimenez JF, Lopez Jimenez M, et al: Clenbuterol poisoning. Clinical and analytical data on an outbreak in Mostoles, Madrid. Rev Clin Esp 1997; 197(2):92-5.
13. Dawson J: Beta agonists put meat in the limelight again. Br Med J 1990; 301:1238-9.
14. Martinez-Navarro JF: Food poisoning related to consumption of illicit beta-agonist in liver. Lancet 1990; 336(8726):1311.
15. Maistro S, Chiesa E, Angeletti R, Brambilla G: Beta blockers to prevent clenbuterol poisoning. Lancet 1995; 346(8968):180.
16. Brambilla G, Loizzo A, Fontana L, et al: Food poisoning following consumption of clenbuterol-treated veal in Italy. JAMA 1997; 278(8):635.
17. Chan TY: Food-borne clenbuterol may have potential for cardiovascular effects with chronic exposure (commentary). J Toxicol Clin Toxicol 2001; 39(4):345-8.
18. Muscling in on clenbuterol [editorial]. Lancet 1992; 340(8816):403.
19. Spann C, Winter ME: Effect of clenbuterol on athletic performance. Ann Pharmacother 1995; 29(1):75-7.
20. Goldstein DR, Dobbs T, Krull B, Plumb VJ: Clenbuterol and anabolic steroids: A previously unreported cause of myocardial infarction with normal coronary arteriograms. South Med J 1998; 91(8):780-4.
21. Cortes-Belen E, Suvak MK, Benitez JG: Clenbuterol overdose in a young female (abstract). J Tox-Clin Tox 1998; 36:510-11.
22. Johnson CB: Pennsylvania Department of Health, Health Alert Network, Health Alert #70, Possible Cyanide Intoxication in Heroin Users. Jan 29, 2005.
23. Johnson CB: Pennsylvania Department of Health, Health Alert Network, Health Update #01-05, Updated Information on Contaminated Heroin. Feb 7, 2005. Available at: http://www.dsf.health.state.pa.us/health/cwp/view.asp?A=171&Q= 240866. Accessed: May 3, 2005.
24. Associated Press: Bad heroin in New Jersey, Connecticut. Radio broadcast, Infinity Broadcasting Corp., 1010 WINS Hartford. Feb 11, 2005. Available at: http://1010wins.com/topstories/local_story_041150827.html. Accessed: May 3, 2005.
25. Leighton J: 2005 New York City Department of Health and Mental Hygiene. Health Alert #6, Investigation of Tainted Heroin. 2005 Mar 17. Available at: http://www.nycms.org/article_view.php3?view=1124&part=1. Accessed: May 3, 2005.
26. Kamburoff PL, Prime FJ, Schmidt OP: The bronchodilator effect of NAB 365. Br J Clin Pharmacol 1977; 4(1):67-71.
27. Couet W, Girault J, Reigner BG, et al: Steady-state bioavailability and pharmacokinetics of ambroxol and clenbuterol administered alone and combined in a new oral formulation. Int J Clin Pharmacol Ther Toxicol 1989; 27(9):467-72.
28. Boner AL, Sette L, Castellani C, Schiassi M: Oral clenbuterol and procaterol. A double-blind comparison of bronchodilator effects in children with chronic asthma. J Asthma 1987; 24(6):347-53.
29. Blom-Bulow B, Boe J, Bulow K: A comparison of oral beta2-agonists clenbuterol and salbutamol in obstructive lung disease: A double-blind cross-over study. Curr Ther Res 1985; 37:51-7.
30. Report of the International Narcotics Control Board for 1999 on the Implementation of Article 12 of the United Nations Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances of 1988, Annex II, Substances in Tables I and II of the 1988 Convention and their typical use in the illicit manufacture of narcotic drugs and psychotropic substances. Available at: http://www.incb.org/e/tr/pre/e00xi3/precursors_1999_4_2.pdf. Accessed: May 3, 2005.