Retrospective analysis of 4-fluoroamphetamine in the emergency department
Abstract
Background: 4 fluoroamphetamine (4-FA) is an increasingly popular drug of abuse. Its prevalence increased from 9% in 2013 to 25% in 2016 among Dutch partygoers (15-35 years). Severe complications and their acute onset have been described in the literature, yet a clear clinical description is unavailable. The aim of this study is to provide a clear clinical description, which could lead to early warning signs and thus the prevention of acute deterioration.
Method: this is an observational study. Patients who presented with a 4-FA intoxication at the emergency department (ED) of OLVG hospital in Amsterdam between May 2016 and May 2017 were manually selected from the electronic patient database, based on registration of intoxications. Patients under the age of 18 years and patients with an intoxication of prescribed medications were excluded. Medical files of eligible patients were reviewed. Primary outcomes comprised patient complaints, vital parameters, laboratory result and duration of admission. Secondary outcomes consisted of the need for intervention. IBM SPSS statistics 22 was used to obtain descriptive statistics, where normally distributed continuous variables were presented as mean (standard deviation) and non-normally distributed parameters as median (Inter Quartile Range). For other variables frequencies were presented.
Results: a total of 20 patients were included, comprising 25% mono-intoxications. The average age was 23 (±3.6years) years and most patients where men (55%). Patients were admitted to the ED for an average duration of 2:48 hours (median 2:23 hours, IQR 1:48h – 3:32h) and 2 patients were admitted to the ward. One of which was admitted for observation and another was admitted to the intensive care unit for treatment of acute cardiogenic shock. Patients complained most of nausea (45%) and headache (25%). Complications consisted mainly of hypertension (45%) and tachycardia (40%). 10% of the patients showed a hypertensive emergency and 5% showed a tachycardia of more than 130 beats/min.
Conclusion: this research shows insights in the clinical aspects of 4-FA intoxications, mainly consisting of circulatory complications. Further research is needed to develop early warning signs and potentially prevent the acute deterioration of patients.
