故意直肠使用甲基苯丙胺 "堵塞 "后中毒

IF 1.2 4区 医学 Q3 EMERGENCY MEDICINE
Amye Farag MD, Sean Patrick Nordt MDPharmD, Joshua Perese MD
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引用次数: 0

摘要

背景甲基苯丙胺是一种常用的非法药物。给药途径通常是肠外注射、口服或吸食。病例报告:一名 28 岁的男子因娱乐目的故意直肠给药甲基苯丙胺后 30 分钟内因甲基苯丙胺急性中毒到急诊科就诊。患者出现高血压、心动过速、药物性精神病、肌酸激酶升高,需要快速插管并送入重症监护室。我们的患者出院时没有肠道缺血或损伤的临床证据。为什么急诊医生应该注意这一点?直肠给药甲基苯丙胺被称为 "塞药"、"撞炮"、"keestering "和 "捶屁股"。直肠给药会增加甲基苯丙胺严重急性中毒的风险,因为与口服给药相比,直肠给药绕过了一过性代谢,使甲基苯丙胺的起效更快,生物利用度更高。直肠给药甲基苯丙胺后有可能造成肠系膜缺血和肠道损伤。除了处理拟交感神经中毒症外,还建议对肠道和直肠缺血或损伤进行密切的临床监测。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Methamphetamine Poisoning After "Plugging" Intentional Recreational Rectal Use

Background

Methamphetamine is a commonly used illicit substance. The route of administration is usually parenteral, oral ingestion, or snorting. A less common route of administration is placing in the rectum.

Case Report

A 28-year-old man presented to the emergency department with acute methamphetamine toxicity within 30 min after intentional rectal administration of methamphetamine for recreational purposes. The patient had hypertension, tachycardia, drug-induced psychosis, elevated creatine kinase, and required rapid sequence intubation and admission to the intensive care unit. Our patient had no clinical evidence of bowel ischemia or injury at the time of discharge.

Why Should an Emergency Physician Be Aware of This?

Rectal administration of methamphetamine is known as “plugging,” “booty bumping,” “keestering,” and “butt whacking.” The rectal administration of methamphetamine has the increased risk of severe acute methamphetamine toxicity, as rectal administration bypasses first-pass metabolism, allowing for a more acute onset and higher bioavailability of methamphetamine compared with oral administration. There is the potential for mesenteric ischemia and bowel injury after rectal methamphetamine. Close clinical monitoring for bowel and rectal ischemia or injury are recommended, in addition to management of the sympathomimetic toxidrome.

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来源期刊
Journal of Emergency Medicine
Journal of Emergency Medicine 医学-急救医学
CiteScore
2.40
自引率
6.70%
发文量
339
审稿时长
2-4 weeks
期刊介绍: The Journal of Emergency Medicine is an international, peer-reviewed publication featuring original contributions of interest to both the academic and practicing emergency physician. JEM, published monthly, contains research papers and clinical studies as well as articles focusing on the training of emergency physicians and on the practice of emergency medicine. The Journal features the following sections: • Original Contributions • Clinical Communications: Pediatric, Adult, OB/GYN • Selected Topics: Toxicology, Prehospital Care, The Difficult Airway, Aeromedical Emergencies, Disaster Medicine, Cardiology Commentary, Emergency Radiology, Critical Care, Sports Medicine, Wound Care • Techniques and Procedures • Technical Tips • Clinical Laboratory in Emergency Medicine • Pharmacology in Emergency Medicine • Case Presentations of the Harvard Emergency Medicine Residency • Visual Diagnosis in Emergency Medicine • Medical Classics • Emergency Forum • Editorial(s) • Letters to the Editor • Education • Administration of Emergency Medicine • International Emergency Medicine • Computers in Emergency Medicine • Violence: Recognition, Management, and Prevention • Ethics • Humanities and Medicine • American Academy of Emergency Medicine • AAEM Medical Student Forum • Book and Other Media Reviews • Calendar of Events • Abstracts • Trauma Reports • Ultrasound in Emergency Medicine
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