Teter C J, Guthrie S K
College of Pharmacy, University of Michigan, Ann Arbor 48109-1065, USA.
Pharmacotherapy. 2001 Dec;21(12):1486-513. doi: 10.1592/phco.21.20.1486.34472.
"Club drugs" have become alarmingly popular. The use of 3,4-methylenedioxymethamphetamine (MDMA, Ecstasy) and gamma-hydroxybutyrate (GHB), in particular, has increased dramatically from 1997-1999. The pharmacokinetics of MDMA and GHB appear to be nonlinear, making it difficult to estimate a dose-response relationship. The drug MDMA is an amphetamine analog with sympathomimetic properties, whereas GHB is a gamma-aminobutyric acid analog with sedative properties. Symptoms of an MDMA toxic reaction include tachycardia, sweating, and hyperthermia. Occasional severe sequelae include disseminated intravascular coagulation, rhabdomyolysis, and acute renal failure. Treatment includes lowering the body temperature and maintaining adequate hydration. Symptoms of GHB intoxication include coma, respiratory depression, unusual movements, confusion, amnesia, and vomiting. Treatment includes cardiac and respiratory support. Because of the popularity of these agents and their potentially dangerous effects, health care professionals must be familiar with these substances and the treatment options for patients who present with symptoms of a toxic reaction.
“俱乐部毒品”已变得极其流行。尤其是3,4－亚甲基二氧甲基苯丙胺（摇头丸）和γ－羟基丁酸（GHB）的使用量在1997年至1999年间急剧增加。摇头丸和GHB的药代动力学似乎是非线性的，因此难以估计剂量反应关系。摇头丸是一种具有拟交感神经特性的苯丙胺类似物，而GHB是一种具有镇静特性的γ－氨基丁酸类似物。摇头丸中毒反应的症状包括心动过速、出汗和体温过高。偶尔出现的严重后遗症包括弥散性血管内凝血、横纹肌溶解和急性肾衰竭。治疗方法包括降低体温和维持充足的水合作用。GHB中毒的症状包括昏迷、呼吸抑制、异常运动、意识模糊、失忆和呕吐。治疗方法包括心脏和呼吸支持。鉴于这些药物的流行及其潜在的危险影响，医护人员必须熟悉这些物质以及出现中毒反应症状的患者的治疗选择。
