Quantification by HPLC-MS/MS of Atropine in Human Serum and Clinical Presentation of Six Mild-to-Moderate Intoxicated Atropine-Adulterated-Cocaine Users

An unexpectedly high number of initially suspected cocaine-intoxicated patients was presented to a general hospital in Lelystad, The Netherlands. Based on the unusual toxidram rate of not fitting cocaine intoxication, the suspicion of co-presence of an anticholinergic agent was raised. A newly developed HPLC-MS/MS analytical method revealed the presence of 10% atropine in a cocaine sample retrieved and subsequently in the sera of 6 intoxicated patients.