Intoxicación severa por 3,4-metilendioximetanfetamina (MDMA). Reporte de caso

Autores/as

DOI:

https://doi.org/10.53732/rccsalud/2024.e6210

Palabras clave:

N-Metil-3,4-metilenodioxianfetamina, simpaticomiméticos, intoxicación, serotoninérgicos

Resumen

La intoxicación por 3,4-metilendioximetanfetamina (MDMA), ha tenido un dramático resurgimiento desde 1980, se ha extendido por gran parte de los Estados Unidos, Europa y América, ha sido ampliamente utilizada como drogas con fines recreativos, actualmente Las catinonas sintéticas se venden como "euforizantes legales" para eludir las leyes existentes, lo que resulta en toxicidad grave y muertes. Presentamos un caso clínico de un adulto joven, quien debuto con intoxicación aguda severa MDMA, con falla multiorgánica, el cual se realizó atención y manejo agudo de la intoxicación en el servicio de urgencias, con posterior manejo de complicaciones en la unidad de cuidados intensivo y finalmente con sobrevida a pesar del mal pronóstico.

Citas

Vogels N, Brunt TM, Rigter S, van Dijk P, Vervaeke H, Niesink RJ. Content of ecstasy in the Netherlands: 1993-2008. Addiction. 2009;104(12):2057-66. https://doi.org/10.1111/j.1360-0443.2009.02707.x

White JM, Bochner F, Irvine RJ. The agony of "ecstasy". Med J Aust. 1997;166(3):117-8. https://doi.org/10.5694/j.1326-5377.1997.tb140037.x

Gough B, Ali SF, Slikker W Jr, Holson RR. Acute effects of 3,4-methylenedioxymethamphetamine (MDMA) on monoamines in rat caudate. Pharmacol Biochem Behav. 1991;39(3):619-23. https://doi.org/10.1016/0091-3057(91)90137-Q

Robledo P. Las anfetaminas. Trastornos Adictivos, 2008;10(3):166–174. https://doi.org/10.1016/S1575-0973(08)76363-3

Lewis N, Howland M, Lewis N, Smith S, Goldman L, Hoffman R. Amphetamines. In Goldfrank’s Toxicologic Emergencies. 11th ed. 2009. 1099-1107 pp.

Henry JA, Jeffreys KJ, Dawling S. Toxicity and deaths from 3,4-methylenedioxymethamphetamine (“ecstasy”). The Lancet. 1992; 340(8816):384–387. https://doi.org/10.1016/0140-6736(92)91469-O

Paratz ED, Cunningham N, MacIsaac AI. The Cardiac Complications of Methamphetamines. Heart, Lung and Circulation. 2015;25(4):325–332. https://doi.org/10.1016/j.hlc.2015.10.019

Herr RD, Caravati EM. Acute transient ischemic colitis after oral methamphetamine ingestion. The American Journal of Emergency Medicine. 1991;9(4):406–409. https://doi.org/10.1016/0735-6757(91)90073-s

Jones, Simpson. Review article: mechanisms and management of hepatotoxicity in ecstasy (MDMA) and amphetamine intoxications. Alimentary Pharmacology and Therapeutics. 1999;13(2):129–133. https://doi.org/10.1046/j.1365-2036.1999.00454.x

Eskandari MR, Rahmati M, Khajeamiri AR, Kobarfard F, Noubarani M, Heidari H. A new approach on methamphetamine-induced hepatotoxicity: involvement of mitochondrial dysfunction. Xenobiotica, 2013;44(1):70–76. https://doi.org/10.3109/00498254.2013.807958

Matsumoto RR, Seminerio MJ, Turner RC, Robson MJ, Nguyen L, Miller DB, et al. Methamphetamine-induced toxicity: An updated review on issues related to hyperthermia. Pharmacology & Therapeutics, 2014;144(1):28–40. https://doi.org/10.1016/j.pharmthera.2014.05.001

Richards JR, Johnson EB, Stark RW, Derlet RW. Methamphetamine abuse and rhabdomyolysis in the ED: A 5-year study. The American Journal of Emergency Medicine, 1999;17(7):681–685. https://doi.org/10.1016/s0735-6757(99)90159-6

Bryden AA, Rothwell PJ, O'Reilly PH. Urinary retention with misuse of "ecstasy". BMJ. 1995;310(6978):504. https://doi.org/10.1136/bmj.310.6978.504a

Abuso de la MDMA (éxtasis) - Reporte de investigación. In National Institute on Drug Abuse. 2021.

Fallon JK, Shah D, Kicman AT, Hutt AJ, Henry JA, Cowan DA, Forsling M. Action of MDMA (ecstasy) and its metabolites on arginine vasopressin release. Ann N Y Acad Sci. 2002;965(1):399-409. https://doi.org/10.1111/j.1749-6632.2002.tb04181.x

Derlet RW, Rice P, Zane Horowitz B, Lord RV. Amphetamine toxicity: Experience with 127 cases. The Journal of Emergency Medicine. 1989;7(2):157–161. https://doi.org/10.1016/0736-4679(89)90263-1

Solursh LP. Use of diazepam in hallucinogenic drug crises. JAMA. 1968;205(9):644. https://pubmed.ncbi.nlm.nih.gov/5695106/

Wu CS, Tsai YT, Tsai HJ. Antipsychotic Drugs and the Risk of Ventricular Arrhythmia and/or Sudden Cardiac Death: A Nation‐wide Case‐Crossover Study. J A Heart Assoc. 2015;4(2):e001568. https://doi.org/10.1161/jaha.114.001568

Muench J, Hamer AM. Adverse effects of antipsychotic medications. Am Fam Physician. 2010;81(5):617-22. https://www.aafp.org/pubs/afp/issues/2010/0301/p617.html

Laskowski LK, Landry A, Vassallo SU, Hoffman RS. Ice water submersion for rapid cooling in severe drug-induced hyperthermia. Clinical Toxicology. 2015;53(3):181–184. https://doi.org/10.3109/15563650.2015.1009994

Grunau BE, Wiens MO, Brubacher JR. Dantrolene in the treatment of MDMA-related hyperpyrexia: a systematic review. CJEM, 2010;12(5):435–442. https://doi.org/10.1017/s1481803500012598

Kolb ME, Horne ML, Martz, R. Dantrolene in human malignant hyperthermia a multicenter study. Anesthesiology. 1982;56(4):254–262. https://doi.org/10.1097/00000542-198204000-00005

McKinney PE, Tomaszewski C, Phillips S, Brent J, Kulig K. Methamphetamine toxicity Prevented by activated charcoal in a mouse model. Annals of Emergency Medicine. 1994;24(2):220–223. https://doi.org/10.1016/s0196-0644(94)70133-4.

Li J, Li J, Chen Y, Xu Y, Li W, Chen Y, et al. Methamphetamine use associated with monomorphic ventricular Tachycardia. J Addict Med. 2014;8(6):470–473. https://doi.org/10.1097/adm.0000000000000069

Jacobs W. Fatal amphetamine-associated cardiotoxicity and its medicolegal implications. Am J Forensic Med Pathol. 2006;27(2):156-60. https://doi.org/10.1097/01.paf.0000188082.68009.10

Bowen JS. Diffuse Vascular Spasm Associated with 4-Bromo-2,5-Dimethoxyamphetamine Ingestion. JAMA. 1983;249(11):1477. https://jamanetwork.com/journals/jama/article-abstract/384921

Publicado

2024-04-11

Cómo citar

Cetina Estepa, J. E., Cubillos Rojas, J. D., Orjuela Salazar , L., Serrano Giraldo, J., Camargo Arenas, J. F., & Casas, O. (2024). Intoxicación severa por 3,4-metilendioximetanfetamina (MDMA). Reporte de caso. Revista científica Ciencias De La Salud, 6, 01–11. https://doi.org/10.53732/rccsalud/2024.e6210