Table 1. Summary of pharmacological components present in the white powder taken by the patient.

Molecule	Mechanism of action	Effects	Potential risk
Methylenedioxypyrovalerone	Norepinephrine-dopamine reuptake inhibitor	Psychic: euphoria, increased wakefulness (severe insomnia) Physical: tachycardia, hypertension	Hyperthermia 3, 4
Mephedrone	Serotonin-dopamine reuptake inhibitor, pre-synaptic monoamine release	Psychic: elevated mood, hallucinations, delusions, sexual stimulation Physical: tachycardia, hypertension, breath depression, increased sweating, teeth grinding	Stroke, heart failure, hyperthermia
Butylone	Dopamine reuptake inhibitor, serotonin receptor 2A agonist	Psychic: mild euphoria Physical: nystagmus, increased body temperature, teeth grinding	Rhabdomyolysis, hyperthermia, acute renal failure
Alpha-Pyrrolidinopentiophenone (a-PVP)	Norepinephrine-dopamine reuptake inhibitor	Psychic: euphoria, anxiety Physical: tachycardia, hypertension	Hyperthermia