Olives TD, Orozco BS, Stellpflug SJ.
“Bath salts: the ivory wave of trouble”.
West J Emerg Med. 2012 Feb 30;13(1):58-62.
Mephedrone and MDPV are both b-ketophenethylamine
derivatives of cathinone, a compound isolated from the East
African plant Catha edulis (khat, qat). Mephedrone is
commonly referred to as plant food, MCAT, 4-MMC, meow
meow, meph, and drone; MDPV is commonly called MTV,
MDPK, Magic, and Super Coke. Both are structurally similar
to amphetamines, with mephedrone sharing close similarities
with methamphetamine and MDPV with ecstasy (3,4-
methylenedioxymethamphetamine; MDMA). Bath salts pose
an increasing public health risk in the United States, with
reports of toxicity and mortality increasing along with calls to
poison centers throughout the United States. Packages labeled
with innocuous monikers such as White Ice, Ivory Wave, Ocean
Snow, Lunar Wave, and Vanilla Sky intentionally belie the
dangerous substances within, which are by no means intended
to replace legitimate bath products. The white or tan crystalline
powder commonly is administered by nasal insufflation or oral
ingestion; however, rectal suppository and less commonly,
intramuscular or intravenous injection, are also reported.1,2
A movement to ban these substances is growing in the
United States, following similar actions in Europe.3 Although
successfully outlawed in some locales, this movement has not
eliminated the public health hazards posed by mephedrone or
MDPV. Emergency physicians (EP) should thus be
knowledgeable in the epidemiology of bath salt abuse, the
clinical toxidrome with which bath salt toxicity presents, and
appropriate treatment strategies to reduce morbidity and
mortality in patients presenting with bath salt toxicity.