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MDMA toxicity: management of acute and life-threatening presentations

Nicola Davies1, William English2, Johann Grundlingh3

  • 1Senior Sister, Emergency Department, Royal London Hospital.

British Journal of Nursing (Mark Allen Publishing)
|June 13, 2018
PubMed

Insights

Methylenedioxymethamphetamine (MDMA) use has risen, leading to increased deaths. This review covers MDMA toxicity, patient symptoms, and treatments, including extracorporeal membrane oxygenation.

Area of Science:

  • Toxicology
  • Emergency Medicine
  • Pharmacology

Background:

  • Methylenedioxymethamphetamine (MDMA), a popular recreational drug, has seen a resurgence in use.
  • This increase is associated with a rise in MDMA-related fatalities.
  • The complex pathophysiology of MDMA toxicity requires further understanding.

Purpose of the Study:

  • To enhance reader knowledge of MDMA toxicity.
  • To detail patient presentations and the pathophysiology of life-threatening MDMA toxicity.
  • To review current treatments and explore extracorporeal membrane oxygenation (ECMO) as a potential therapy.

Main Methods:

  • Literature review of MDMA toxicity.
  • Analysis of patient presentations and clinical outcomes.
  • Review of existing treatment protocols for MDMA overdose.
  • Evaluation of ECMO's role in severe MDMA toxicity.

Main Results:

  • MDMA toxicity presents with a complex and potentially fatal pathophysiology.
  • Current treatments focus on supportive care and managing specific toxic effects.
  • Extracorporeal membrane oxygenation (ECMO) shows promise as a rescue therapy for refractory cases.

Conclusions:

  • Understanding MDMA toxicity is crucial for effective patient management.
  • Prompt recognition of patient presentations and timely intervention are key.
  • ECMO may offer a life-saving option for patients with severe, treatment-resistant MDMA toxicity.
Keywords:
Cardiac arrestExtracorporeal membrane oxygenationMDMAMethylenedioxymethamphetamineSerotonin syndromeToxicology

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