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Amphetamines and acute renal failure

Mohammed A Al Shehri, Ali A Youssef
A 35-year-old man of average build and a smoker, with a background of a psychiatric disorder, was brought by his neighbor to the emergency department after an hour of severe chest pain. Upon arrival at the hospital he had cardiac arrest, was resuscitated, and moved to the catheterization laboratory with inferior, posterior, and lateral myocardial infarction. Coronary angiography showed an unusual thrombosis in multiple coronary branches. Toxicology report showed high levels of amphetamines and benzodiazepines in the patient's original blood sample...
July 2016: Journal of the Saudi Heart Association
Matthias Liechti
Novel psychoactive substances are newly used designer drugs ("internet drugs", "research chemicals", "legal highs") potentially posing similar health risks to classic illicit substances. Chemically, many novel psychoactive substances can be classified as phenethylamines, amphetamines, synthetic cathinones, piperazines, pipradrols/piperidines, aminoindanes benzofurans, and tryptamines. Pharmacologically, these substances interact with various monoaminergic targets. Typically, stimulants inhibit the transport of dopamine and noradrenaline (pipradrols, pyrovalerone cathinones) or induce the release of these monoamines (amphetamines and methamphetamine-like cathinones), entactogens predominantly enhance serotonin release (phenylpiperazines, aminoindanes, para-substituted amphetamines, and MDMA-like cathinones) similar to MDMA (ecstasy), and hallucinogens (tryptamines, hallucinogenic phenethylamines) are direct agonists at serotonergic 5-HT2A receptors...
2015: Swiss Medical Weekly
Marek Wiergowski, Jacek Sein Anand, Maciej Krzyżanowski, Zbigniew Jankowski
Methoxetamine (MXE) is a psychoactive substance distributed mostly via the Internet and is not liable to legal regulation in Poland. MXE has a toxicity profile similar to that of ketamine but longer-lasting effects. The paper describes a case of acute poisoning that resulted from recreational use of MXE and amphetamine and ended in death. In mid-July 2012, a 31-year old man was admitted to the clinical toxicology unit in Gdańsk because of poisoning with an unknown psychoactive substance. The patient was transported to the emergency department (ED) at 5:15 a...
August 2014: International Journal of Occupational Medicine and Environmental Health
Grerk Sutamtewagul, Vineeta Sood, Kenneth Nugent
"Bath salts" is a well known street drug which can cause several cardiovascular and neuropsychiatric symptoms. However, only one case of acute kidney injury has been reported in the literature. We present a case with sympathomimetic syndrome, choreoathetosis, gustatory and olfactory hallucinations, and acute kidney injury following the use of bath salts. A 37-year-old man with past medical history of hypertension and depression was brought to the emergency center with body shaking. Three days before admission he injected 3 doses of bath salts intravenously and felt eye pain with blurry vision followed by a metallic taste, strange smells, profuse sweating, and body shaking...
January 2014: Clinical Nephrology
A Malin, J Freyhoff, W Nobis, H G Bone
A case report of severe rhabdomyolysis in a 33-year-old motorcyclist after multiple trauma is described. The injuries included severe thoracic and abdominal trauma as well as injuries to the extremities and spinal column. During the first 3 days of treatment a forced volume therapy was performed because of increased levels of creatine kinase during which the patients condition stabilized both hemodynamically and respiratorily. On day 10 the patient developed a rise in temperature to 42°C with no evidence of a re-infection and the creatine kinase levels rose to 109,830 U/l...
March 2012: Der Anaesthesist
Tor-Bjarne Nymark, Hedda Soløy-Nilsen, Rolf Steen, Erik Waage Nielsen
MATERIAL AND METHODS: A 38-year-old psychostimulant abuser was admitted to hospital after syncope. He had lost much of his weight over the last 6 months, had abdominal pain the last 10 days and bloody diarrhoea and hypotension upon admittance. The abdomen was soft and non-tender. Due to renal failure and metabolic acidosis with base excess of -16 to -22 mmol/L and lactate from 9.5 to 16 mmol/L, haemodialysis was given twice. Acidosis worsened. He suffered from respiratory arrest twice and was resuscitated once before a laparotomy 30 hours after admittance revealed total ischemia of the bowels...
February 1, 2007: Tidsskrift for Den Norske Lægeforening: Tidsskrift for Praktisk Medicin, Ny Række
Alisan Kahraman, Michael Miller, Robert K Gieseler, Guido Gerken, Michael J Scolaro, Ali Canbay
Non-alcoholic fatty liver disease is a prominent feature in HIV-positive patients. We present two patients with long-lasting HIV-infection who suffered from this disease, as induced by highly active anti-retroviral therapy (HAART). The patients developed acute-on-chronic (AOC) liver failure after either (case 1) acute infection with hepatitis A virus (HAV) or (case 2) methamphetamine abuse ('Ecstasy'). Approximately 1 week after visiting an area endemic for HAV, case 1, a male patient, presented with icterus, elevated liver transaminases and HAV IgM...
January 2006: European Journal of Gastroenterology & Hepatology
Anna Kunsdorf-Wnuk, Ewa Musioł, Ewa Karpel, Danuta Arct-Danielak
More often we are faced with the cases of young people (who are in a serious condition) who land in ICU, because of severe narcotics intoxication, which they took occasionally on the concerts, discotheques and social events. From 1997 we observed rapid increase of admission to hospitals due to amphetamine, MDMA (2,3-methylenedeoxymethamphetamine which is a main component of a tablet called ecstasy) and THC (9-d tetrahydrocannabinols which are a component of sunn hemps) intoxication and decrease of opioid's poisoning...
April 2005: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
Magdalena Lukasik-Głebocka, Roman Wachowiak, Andrzej Kostrzewa, Michał Karlikowski, Wojciech Mańkowski, Janusz Kołowski
Intoxications with amphetamine derivatives represent an important problem of clinical and forensic toxicology. Even if distribution of the drug group has been legally forbidden, they continue to pose serious threats, linked to their uncontrolled administration which frequently leads to lethal intoxications. We present a case of intoxication in a 17-year-old male with amphetamine derivate--MDMA, Ecstasy. Clinical analysis documented an acute multi-organ failure, in particular pronounced hepatic and renal insufficiency, disseminated intravascular clotting (DIC)...
2004: Przegla̧d Lekarski
Akiko Ishigami, Itsuo Tokunaga, Takako Gotohda, Shin-ichi Kubo
It is known that methamphetamine (MA) causes rhabdomyolysis, myoglobinuria, and acute renal failure. We conducted an immunohistochemical study on the kidney of 22 forensic autopsy cases in which MA had been detected. Myoglobin was positive in 17 cases. The concentration of the blood MA in the myoglobin-positive cases (8.39+/-3.43 micromol/dl) was higher than -negative cases (0.198+/-0.076 micromol/dl). And, the 70 kDa heat shock protein (HSP70), 8-hydroxy-2'-deoxyguanosine (8-OH-dG), 4-hydroxy-2-nonenal (4-HNE), and Cu/Zn superoxide dismutase (SOD) were also stained positively in five, ten, 11, nine cases of examined, respectively...
March 2003: Legal Medicine
O Núñez, R Bañares, J Barrio, L Menchén, A de Diego, E Salinero, G Clemente
3,4-methylenedioxymethamphetamine (MDMA) is an amphetamine derivative, known as ecstasy. Because of its euphoric effects, the use of this substance as a drug of abuse is becoming increasingly widespread. The development of hyperthermia, disseminated intravascular coagulation, rhabdomyolysis, acute renal failure, cardiac arrhythmia and neurotoxicity have been described in association with the use of this drug. Moreover, in the last few years, cases of liver involvement, associated or not with the above-mentioned entities, have been described, ranging from mild acute hepatitis to fulminant hepatic failure and death...
October 2002: Gastroenterología y Hepatología
S Raza Ali, M Krugar, J Houghton
We describe the case of a 14-year-old boy who developed airway obstruction due to acute upper respiratory tract infection. Following emergency tracheostomy, he developed pulmonary oedema and required ventilation. The postoperative course was complicated by the development of adult respiratory distress syndrome, characterised by marked respiratory distress, diffuse pulmonary infiltrates on chest radiography, reduced pulmonary compliance and marked increase in alveolar-arterial oxygen difference. He also developed persistent high-grade pyrexia, renal failure and cardiac instability...
July 2002: International Journal of Clinical Practice
S R Orth
The most important task of clinical and experimental nephrology is to identify risk factors for progression of renal failure with the ultimate goal to counteract the dramatic increase of patients reaching end-stage renal disease. Recently, cigarette smoking has been recognized to be one of the most important remediable renal risk factors. The adverse renal effects of smoking seem to be independent of the underlying renal disease and the current evidence suggests a near doubling of the rate of progression in smokers vs...
March 2002: Therapeutische Umschau. Revue Thérapeutique
C J Teter, S K Guthrie
"Club drugs" have become alarmingly popular. The use of 3,4-methylenedioxymethamphetamine (MDMA, Ecstasy) and gamma-hydroxybutyrate (GHB), in particular, has increased dramatically from 1997-1999. The pharmacokinetics of MDMA and GHB appear to be nonlinear, making it difficult to estimate a dose-response relationship. The drug MDMA is an amphetamine analog with sympathomimetic properties, whereas GHB is a gamma-aminobutyric acid analog with sedative properties. Symptoms of an MDMA toxic reaction include tachycardia, sweating, and hyperthermia...
December 2001: Pharmacotherapy
J R Richards, E B Johnson, R W Stark, R W Derlet
Patients with methamphetamine toxicity are presenting in greater numbers each year to emergency departments (ED) in the US. These patients are frequently agitated, violent, and often require physical and chemical restraint. The incidence and risk of rhabdomyolysis in this subpopulation is unknown. We conducted a 5-year retrospective review of all ED patients who received the final diagnosis of rhabdomyolysis. Patients with toxicology screens positive for methamphetamine were identified, and demographics, laboratory results, resource utilization, disposition, and outcome were compared to the remaining patients...
November 1999: American Journal of Emergency Medicine
J P Liberg, K E Hovda, G Nordby, D Jacobsen
The amphetamine derivative MDMA (3,4-methylenedioxymethamphetamine) was first synthesised in 1914 as an appetite suppressant, but was never used as such. MDMA is commonly known as "ecstasy" and has become a popular recreational drug of abuse at dance-clubs and rave parties, where it is combined with all-night dancing, crowded conditions, poor hydration and loud sound. This combination is probably the main reason why we have seen an upsurge in toxicity problems at rave parties, since all these factors are thought to promote or increase the toxicity of MDMA...
November 20, 1998: Tidsskrift for Den Norske Lægeforening: Tidsskrift for Praktisk Medicin, Ny Række
K C Lan, Y F Lin, F C Yu, C S Lin, P Chu
The prevalence of amphetamine abuse and the frequency of emergency department visits for amphetamine intoxication have increased dramatically worldwide. In this study, we retrospectively investigated the relationship between the prognostic features and clinical manifestations among patients admitted to the emergency department of a university hospital for acute methamphetamine intoxication during a 6-year period. Data collected included gender, age, route of abuse, time between drug exposure and arrival at the emergency department, estimated dose, signs and symptoms, laboratory values, and complications...
August 1998: Journal of the Formosan Medical Association, Taiwan Yi Zhi
V Trkulja, Z Lacković
"Ecstasy" (3,4-methylenedioxymethamphetamine, MDMA) is a prototype of a class of amphetamine derivatives that selectively destroy serotonergic neurons in several brain regions of various species, including, most probably, humans. Due to its psychostimulant and psychodelic effects, "Ecstasy" has been increasingly abused, especially in association with the "Rave" (sub)culture. However, it is not an innocent stimulant. At least 30 cases of severe psychiatric disturbances (chronic psychoses, panic disorders, suicides) induced by recreational doses of "Ecstasy" have been reported during the past 10 years in periodicals included in MEDLINE data base...
May 1997: Lijec̆nic̆ki Vjesnik
S R Sultana, D J Byrne
Strenuous exertion is a recognized cause of haematuria but full investigation is still required to exclude any serious underlying pathology. Heavy exercise and amphetamine abuse can both cause rhabdomyolysis and acute renal failure. The recent popularity of 'rave parties' has highlighted these problems in young people who attend the all-night dance parties where a minority of them abuse drugs such as amphetamines. We describe a case of rhabdomyolysis following ingestion of amphetamines during a rave party, where the patient was diagnosed early, presenting acutely with frank haematuria...
December 1996: Journal of the Royal College of Surgeons of Edinburgh
A A Bakir, G Dunea
The complications of drug abuse encompass a spectrum of glomerular, interstitial, and vascular diseases. They comprise the heroin-associated nephropathy seen in African-American intravenous drug addicts, which, however, has given way in the 1990s to HIV-associated nephropathy. Infections with methicillin-resistant Staphylococcus aureus may cause acute glomerulonephritis by releasing bacterial superantigens. Hepatitis C has supplanted hepatitis B and may give rise to membranoproliferative glomerulonephritis and cryoglobulinemia...
March 1996: Current Opinion in Nephrology and Hypertension
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