( 3,4,methylenedioxymethamphetamine) Ecstasy

2. (3,4,methylenedioxymethamphetamine)Ecstasy • A designer amphetamine that has become one of the most widely abused drugs in the adolescents • A blending of sympathomimetic amphetamine stimulation with the hallucinogenic effects of mescaline • The drug is popular at “rave “ parties and at dance clubs. • Following ingestion, the onset of action is 30 – to 90 minutes, plateau effects are achieved in 2- 3 hours • The drug is abused because it induces extreme euphoria, increased energy, feeling of belongings, heightened sensations, empathy, music appreciation

3. Bruxism Trismus Short-term memory loss Confusion Headches Vertigo Ataxia Vomiting Depression&psychological addiction Profound hyperthermia Hypertension Seizures Dehydration Hyponatremi Hepatic and renal failure Rhabdomyolysis MI & ICH Toxic effects & Major complications

4. Psychological • Euphoria • Closeness to others • love drug • Serotonergic properties • Shimmering visual effects

5. Differential Diagnosis • Amphetamines • LSD • Phencyclidine abuse

6. Management • Supportive care, airway management, rapid cooling • Liberal doses of benzodiazepines for tachycardia,hypertension, and agitation • Activated charcoal • Toxicology urine screens that are marketed to detect amphetamines can be negative after ecstacy and desighner amphetamine use • Fluid

7. Management • Consultation with a local or regional poison center • Observation for4 to 6 hours • Because of 10 -50% repeat ingestion, families must be received a kind of instuction about poison prevention • Admission to the hospital(slow release substances and or ingestion of significant amounts of drug • A conservative approach for toxins that can cause potential mortality in small doses (camphor, benzocaine, lomotil, chloroquin, methyl salicylate • All patients with intentional overdoses should undergo psychiatric assessment