| Title |
Adverse effects of levamisole in cocaine users: a review and risk assessment
|
|---|---|
| Published in |
Archives of Toxicology, March 2017
|
| DOI | 10.1007/s00204-017-1947-4 |
| Pubmed ID | |
| Authors |
Tibor Markus Brunt, Jorrit van den Berg, Ed Pennings, Bastiaan Venhuis |
| Abstract |
The immunomodulatory adjuvant and antihelminth levamisole is increasingly used as an adulterant in cocaine worldwide. An accumulating body of clinical and toxicological literature has appeared since 2010 describing neutropenia, agranulocytosis, leukoencephalopathy and vasculitis in cases associated with levamisole-adulterated cocaine. Mostly, neutropenia and agranulocytosis were reported, characterized by a decimation of neutrophils. A large proportion of cases also involved vasculopathy, characterized by pronounced black and purple skin purpura with cutaneous necrosis. Females are more susceptible for both agranulocytosis and vasculitis. Another complication reported with levamisole-adulterated cocaine is leukoencephalopathy, a disabling and potentially fatal neurological disorder caused by cerebral demyelination. In this review, all adverse effects associated with therapeutic levamisole and levamisole-adulterated cocaine are described. In addition, this review provides an update of the pharmacology of levamisole, its metabolism, including toxic metabolites and metabolites that are relevant for levamisole's addition to cocaine. Special emphasis is put on the immunopathology and the dose-effect relationship of chronic levamisole exposure. Finally, a risk assessment is provided based on the current level of levamisole adulteration in street cocaine, the dose range calculated per gram and the pattern of chronic exposure in heavy or dependent users. |
X Demographics
The data shown below were collected from the profile of 1 X user who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Portugal | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Scientists | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 94 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 94 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 13 | 14% |
| Student > Master | 12 | 13% |
| Student > Bachelor | 12 | 13% |
| Student > Ph. D. Student | 11 | 12% |
| Other | 6 | 6% |
| Other | 17 | 18% |
| Unknown | 23 | 24% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 22 | 23% |
| Psychology | 7 | 7% |
| Pharmacology, Toxicology and Pharmaceutical Science | 6 | 6% |
| Neuroscience | 6 | 6% |
| Immunology and Microbiology | 5 | 5% |
| Other | 17 | 18% |
| Unknown | 31 | 33% |
Attention Score in Context
This research output has an Altmetric Attention Score of 8. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 27 April 2018.
All research outputs
#3,944,511
of 23,567,572 outputs
Outputs from Archives of Toxicology
#379
of 2,665 outputs
Outputs of similar age
#74,988
of 335,391 outputs
Outputs of similar age from Archives of Toxicology
#5
of 24 outputs
Altmetric has tracked 23,567,572 research outputs across all sources so far. Compared to these this one has done well and is in the 82nd percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 2,665 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.3. This one has done well, scoring higher than 85% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 335,391 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 77% of its contemporaries.
We're also able to compare this research output to 24 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 79% of its contemporaries.