Citation

Roset Ferrer C, Gomila Muñiz I, Elorza Guerrero MÁ, Puiguriguer Ferrando J, Leciñena Estean MÁ, Tuero León G, Sahuquillo Frías L, Ripoll Vera T, Socias Crespi L, Sanchís Cortés P, Barcelo Martin B. Emergencias 2020; 32(1): 26-32.

Vernacular Title

Intoxicaciones por anfetamina y metanfetamina atendidas en los servicios de urgencias: características clínicas y utilidad de la confirmación analítica.

Affiliation

Instituto de Investigación Sanitaria de las Islas Baleares (IdISBa), Palma de Mallorca, España. Servicio de Análisis Clínicos, Unidad de Toxicología Clínica, Hospital Universitari Son Espases, Palma de Mallorca, España.

Copyright

(Copyright © 2020, SEMES - Sociedad Española de Medicina de Urgencias y Emergencias)

DOI

unavailable

PMID

31909909

Abstract

OBJECTIVES: To determine whether clinical and toxicologic findings differed between cases of amphetamine (AMP) and methamphetamine (mAMP) poisoning attended in 2 Balearic Island hospital emergency departments. MATERIAL AND METHODS: Retrospective observational study of AMP and mAMP cases with laboratory confirmation between 2013 and 2018. We compared clinical and toxicologic variables as well as clinical management between groups.

RESULTS: 1) A total of 120 cases were found: 86 (71.7%) with AMP poisoning and 34 (28.3%) with mAMP poisoning. 2) Drug poisoning was confirmed by gas chromatography associated with mass spectrometry (GC-MS) in 787 urine samples found to be positive during screening. One hundred fifty-four (19.6%) were confirmed by GC-MS. Thirtyfour of them did not meet the inclusion criteria. 3) Significant differences between AMP and mAMP cases were found for age (32.3 vs 28.4 y, respectively); sex (72.1% vs 94.1% men); and Spanish nationality (64.0% vs 29.4%). Reasons for admission and clinical features also differed: the reasons were aberrant behavior (15.1% in the AMP group vs 0% in the mAMP group) and palpitations (1.2% vs 20.6%); agitation was observed in 27.9% and 8.8%, respectively. Clinical management was similar in the 2 groups. Multiple drug poisoning was detected in 76.6% patients and was more common in patients in the AMP group (82.6% vs 61.8%). The additional drugs in these cases were mainly cocaine (63.0%), cannabis (48.9%), 3,4-methylenedioxy-N-methamphetamine (MDMA) (38.0%), and alcohol (35.9%). Cannabis was detected in a significantly higher proportion in the AMP group (45.3%) than in the mAMP group (17.6%). False positives were found in 78.7% of the samples. The culprit drug was most often MDMA (71.2%).

CONCLUSION: AMP poisonings were associated with age over 30 years, Spanish nationality, aberrant behavior, agitation, multiple drug findings, and the use of cannabis. Poisonings caused by mAMP abuse were associated with age under 30 years, non-Spanish nationality, palpitations, and single-drug use.

Language: en

Language: es

Language: es

Language: es

Language: es

Keywords

Anfetamina; Amphetamine; Confirmación analítica; Emergency department; Intoxicaciones; Laboratory confirmation; Metanfetamina; Methamphetamine; Poisoning; Servicio de urgencias