Ingestion of Synthetic Street Drug “25-I” (25I-NBOMe) Causing Type B Lactic Acidosis and Multi-Organ Dysfunction
Bibliographic record
Abstract
25I-NBOMe (25-I) is a novel synthetic agonist of the 5-HT2A receptor. It is used recreationally for its psychedelic properties similar to LSD. Side effects include altered mental status, sympathomimetic symptoms, serotonin syndrome and multiple organ injury. We report a case of delayed type B lactic acidosis after ingestion of 25-I. A 16-year-old male presented after being found obtunded. He developed seizures requiring endotracheal intubation. He developed a lactic acidosis about 30 hours after ingestion, peaking at 8.5 mEq/L 38 hours post-ingestion. Concurrently the patient had an elevated mixed venous saturation and decreased arterial-venous oxygen content difference, indicating a type B lactic acidosis. Thiamine, L-carnitine, and coenzyme Q-10 were initiated to treat the metabolic derangement and promote oxygen utilization. Additional treatments included n-acetylcysteine and plasmapheresis. This treatment strategy resulted in reduction in lactate and other markers of organ injury. Arterial-venous oxygen content difference increased to normal levels. The patient made a full recovery. Type B lactic acidosis has been reported previously in a variety of diseases, but never after 25-I ingestion. A novel approach of vitamins and co-factors to support mitochondrial function, n-acetylcysteine and plasmapheresis was employed to treat the lactic acidosis and multi-organ dysfunction successfully. J Med Cases. 2015;6(3):125-127 doi: http://dx.doi.org/10.14740/jmc2023w
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".