PMID- 36187507
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20221004
IS  - 2688-1152 (Electronic)
IS  - 2688-1152 (Linking)
VI  - 3
IP  - 5
DP  - 2022 Oct
TI  - 4-Fluoroamphetamine (4-FA) intoxication results in exaggerated blood pressure 
      effects compared to MDMA and amphetamine: A retrospective analysis.
PG  - e12813
LID - 10.1002/emp2.12813 [doi]
LID - e12813
AB  - OBJECTIVE: 4-Fluoroamphetamine (4-FA) is an amphetamine-type stimulant, with 
      effects comparable to amphetamine and 3,4-methylenedioxymethamphetamine (MDMA). 
      Severe 4-FA-related complications, such as cardiomyopathy, myocardial infarction, 
      and cerebral hemorrhage, have been described. The aim of this study was to 
      explore the cardiovascular symptoms and complications in 4-FA and compare them to 
      MDMA and amphetamine in intoxicated patients who presented to the emergency 
      department (ED). METHODS: Between November 2015 and March 2020, all self-reported 
      4-FA, MDMA, and amphetamine-intoxicated adult patients that presented at the ED 
      of an inner-city hospital in Amsterdam, were retrospectively analyzed for 
      cardiovascular symptoms, vital parameters, cardiovascular complications, 
      interventions, admission rate, and Poisoning Severity Score (PSS). RESULTS: A 
      total of 582 patients were included, of which 31 (5.3%) with 4-FA intoxication 
      (10/31 mono-intoxications, 32.3%), 406 (69.8%) with MDMA (59/406 
      mono-intoxications, 14.5%), 100 (17.2%) with amphetamine (10/100 
      mono-intoxications, 10.0%), and 45 (7.7%) with a cross intoxication of these 
      drugs. 4-FA mono-intoxicated patients experienced more headache (n = 8; 80.0%) 
      compared to MDMA (n = 2; 3.3%; P < 0.001) and amphetamine mono-intoxicated 
      patients (n = 0; 0.0%; P < 0.001) and their systolic blood pressure was higher 
      (164 mm Hg +/- 31 vs 139 mm Hg +/- 19; P = 0.031 vs 135 mm Hg +/- 22; P = 0.033, 
      respectively). Severe 4-FA-related cardiovascular complications included 
      Takotsubo cardiomyopathy (n = 1; 3.2%), subarachnoid hemorrhage (n = 1; 3.2%), 
      and hypertensive urgency (n = 2; 6.5%). CONCLUSIONS: 4-FA intoxication-related ED 
      symptoms resemble MDMA and amphetamine complications, although patients presented 
      more often with headache and hypertension. Severe 4-FA-related cardiovascular 
      complications occurred in 40% of mono-intoxications.
CI  - (c) 2022 The Authors. JACEP Open published by Wiley Periodicals LLC on behalf of 
      American College of Emergency Physicians.
FAU - Gresnigt, Femke M J
AU  - Gresnigt FMJ
AUID- ORCID: 0000-0002-6428-8600
AD  - Department of Emergency Medicine Onze Lieve Vrouwe Gasthuis Hospital AC Amsterdam 
      the Netherlands.
AD  - Dutch Poison Information Center UMC Utrecht, University Utrecht Utrecht the 
      Netherlands.
FAU - Snik, Anouk
AU  - Snik A
AD  - Department of Emergency Medicine Onze Lieve Vrouwe Gasthuis Hospital AC Amsterdam 
      the Netherlands.
FAU - Franssen, Eric J F
AU  - Franssen EJF
AD  - Department of Clinical Pharmacy Onze Lieve Vrouwe Gasthuis Hospital AC Amsterdam 
      the Netherlands.
FAU - Vanhommerig, Joost W
AU  - Vanhommerig JW
AD  - Department of Research and Epidemiology Onze Lieve Vrouwe Gasthuis Hospital AC 
      Amsterdam the Netherlands.
FAU - de Lange, Dylan W
AU  - de Lange DW
AD  - Dutch Poison Information Center UMC Utrecht, University Utrecht Utrecht the 
      Netherlands.
FAU - Riezebos, Robert K
AU  - Riezebos RK
AD  - Heart Center, OLVG Hospital AC Amsterdam the Netherlands.
LA  - eng
PT  - Journal Article
DEP - 20220926
PL  - United States
TA  - J Am Coll Emerg Physicians Open
JT  - Journal of the American College of Emergency Physicians open
JID - 101764779
PMC - PMC9512775
OTO - NOTNLM
OT  - 3,4-methylenedioxymethamphetamine
OT  - 4-FA
OT  - 4-fluoramphetamine
OT  - MDMA
OT  - amphetamine
OT  - cardiovascular complications
OT  - emergency department
COIS- The authors declare no conflicts of interest.
EDAT- 2022/10/04 06:00
MHDA- 2022/10/04 06:01
PMCR- 2022/09/26
CRDT- 2022/10/03 04:53
PHST- 2021/12/14 00:00 [received]
PHST- 2022/02/07 00:00 [revised]
PHST- 2022/02/08 00:00 [accepted]
PHST- 2022/10/03 04:53 [entrez]
PHST- 2022/10/04 06:00 [pubmed]
PHST- 2022/10/04 06:01 [medline]
PHST- 2022/09/26 00:00 [pmc-release]
AID - EMP212813 [pii]
AID - 10.1002/emp2.12813 [doi]
PST - epublish
SO  - J Am Coll Emerg Physicians Open. 2022 Sep 26;3(5):e12813. doi: 
      10.1002/emp2.12813. eCollection 2022 Oct.