(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

Toxic effects & Major complications 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

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

Differential Diagnosis Amphetamines LSD Phencyclidine abuse

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

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