Abstract
Phencyclidine (PCP) is a dissociative drug previously used as an anesthetic agent but caused hallucinations due to its neurotoxic effects. A 49-year-old male farmer attempted suicide at home due to a massive intake of prescription drugs. Toxicological analysis was performed with an immunochromatography test and detected PCP (an uncommon drug in Brazil). Liquid chromatography-tandem mass spectrometry (LC-MS/MS) and in silico models were employed to elucidate this case. Despite the presence of midazolam, fentanyl and lidocaine in urine and serum samples by LC-MS/MS, these drugs and respective metabolites were not able to promote a cross-reaction with PCP as demonstrated by in silico models as well as our practical experience. In fact, doxepin, trimipramine and promethazine and their respective metabolites showed a high correlation interaction in the binding site of 2PCP, especially promethazine. Predicted results obtained on docking show a high correlation interaction between PCP and promethazine, indicating a possible cross-reaction in the immunochromatography test.
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