PMID- 36065452
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220907
IS  - 2090-6420 (Print)
IS  - 2090-6439 (Electronic)
IS  - 2090-6420 (Linking)
VI  - 2022
DP  - 2022
TI  - Dantrolene Administration in the Management of the Prehospital Patient with 
      Methylenedioxymethamphetamine Overdose: A Case Series and Literature Review.
PG  - 5346792
LID - 10.1155/2022/5346792 [doi]
LID - 5346792
AB  - Methylenedioxymethamphetamine (MDMA) is a psychoactive substance that is used 
      commonly as a recreational drug at rave music festivals. MDMA intoxication can 
      cause a myriad of symptoms and side effects including the manifestation of 
      hyperpyrexia in patients. Hyperpyrexia can mimic a heat stroke and ultimately 
      lead to various forms of end-organ damage. The most common methods used in 
      treating MDMA-induced hyperpyrexia focus on the rapid reduction of core body 
      temperature. Various off-label medications have also been used in combating 
      MDMA-induced hyperpyrexia. Dantrolene is one such medication, although its role 
      in the treatment of MDMA intoxication remains uncertain. This case series 
      preliminarily examines the efficacy of dantrolene in mitigating MDMA-induced 
      hyperpyrexia and potentially reducing the risk of end-organ damage in patients 
      suffering from MDMA overdose. This study focuses on nine patients who presented 
      after ingesting various forms of MDMA at "rave" music events. All patients were 
      found to be hyperthermic in the field with a maximum core body temperature of 109 
      degrees Fahrenheit. All patients were immediately managed by cooling measures, 
      and seven patients additionally received dantrolene in the field before being 
      transferred to Arrowhead Regional Medical Center. Upon arrival to the hospital, 
      nearly every patient was found to have significantly decreased body temperatures 
      when compared to previously measured body temperatures out in the field. However, 
      nearly all patients in the study were also noted to have laboratory abnormalities 
      consistent with various forms of end-organ damage. The degree and severity of 
      end-organ damage observed in MDMA-induced hyperpyrexia seem to be a function of 
      initial core body temperature. Higher core body temperature tends to correlate 
      with more forms of end-organ damage and a higher severity of end-organ damage. 
      Intervention with dantrolene and cooling measures appeared to have no effect on 
      reducing the risk of developing end-organ damage in this patient population.
CI  - Copyright (c) 2022 Kia Nikoomanesh et al.
FAU - Nikoomanesh, Kia
AU  - Nikoomanesh K
AUID- ORCID: 0000-0003-4817-001X
AD  - Department of Critical Care Medicine, Arrowhead Regional Medical Center, Colton, 
      CA 92324, USA.
AD  - California University of Science and Medicine, Colton, CA 92324, USA.
FAU - Phan, Alexander T
AU  - Phan AT
AUID- ORCID: 0000-0002-4104-2229
AD  - California University of Science and Medicine, Colton, CA 92324, USA.
AD  - Department of Internal Medicine, Arrowhead Regional Medical Center, Colton, CA 
      92324, USA.
FAU - Choi, Julian
AU  - Choi J
AUID- ORCID: 0000-0002-2177-3526
AD  - Department of Critical Care Medicine, Arrowhead Regional Medical Center, Colton, 
      CA 92324, USA.
AD  - California University of Science and Medicine, Colton, CA 92324, USA.
FAU - Arabian, Sarkis
AU  - Arabian S
AUID- ORCID: 0000-0003-1427-9439
AD  - Department of Critical Care Medicine, Arrowhead Regional Medical Center, Colton, 
      CA 92324, USA.
AD  - California University of Science and Medicine, Colton, CA 92324, USA.
FAU - Neeki, Michael M
AU  - Neeki MM
AUID- ORCID: 0000-0003-0050-0788
AD  - California University of Science and Medicine, Colton, CA 92324, USA.
AD  - Department of Emergency Medicine, Arrowhead Regional Medical Center, Colton, CA 
      92324, USA.
LA  - eng
PT  - Case Reports
DEP - 20220827
PL  - United States
TA  - Case Rep Crit Care
JT  - Case reports in critical care
JID - 101598416
PMC - PMC9440799
COIS- The authors declare that they have no competing interests.
EDAT- 2022/09/07 06:00
MHDA- 2022/09/07 06:01
PMCR- 2022/08/27
CRDT- 2022/09/06 01:52
PHST- 2022/03/31 00:00 [received]
PHST- 2022/08/10 00:00 [accepted]
PHST- 2022/09/06 01:52 [entrez]
PHST- 2022/09/07 06:00 [pubmed]
PHST- 2022/09/07 06:01 [medline]
PHST- 2022/08/27 00:00 [pmc-release]
AID - 10.1155/2022/5346792 [doi]
PST - epublish
SO  - Case Rep Crit Care. 2022 Aug 27;2022:5346792. doi: 10.1155/2022/5346792. 
      eCollection 2022.