The Clinical Toxicology of 4-Bromo-2,5-dimethoxyphenethylamine (2C-B): The Severity of Poisoning After Exposure to Low to Moderate and High Doses - 20/08/20
, Dylan W. de Lange, MD, PhD a, Antoinette J.H. P. van Riel, MSc a, Ruben Q. Vrolijk, MSc b, Dana Ohana, MSc c, Laura Hondebrink, PhD aAbstract |
Study objective |
We studied the severity of poisoning after exposure to low to moderate and high doses of 4-bromo-2,5-dimethoxyphenethylamine (2C-B).
Methods |
Patients for whom the Dutch Poisons Information Centre was consulted for 2C-B exposure from 2016 to 2018 were included in a prospective cohort study. Data were collected through telephone interviews with the physician or patient. Patients were categorized according to the reported 2C-B dose: low to moderate (up to 20 mg), high (greater than 20 mg), or unknown. Presence of 2C-B was analyzed in leftover drug and biological samples with liquid/gas chromatography–mass spectrometry. The severity of poisoning was graded with the Poisoning Severity Score.
Results |
We included 59 patients, of whom 32 could be followed up. Low to moderate 2C-B doses were reported by 9 patients (28%), high doses by 17 (53%), and unknown doses by 6 (19%). Poisoning was moderate in the majority of patients in both the low- to moderate-dose and high-dose groups. Frequently reported symptoms included mydriasis, agitation or aggression, hallucinations, confusion, anxiety, hypertension, and tachycardia. The presence of 2C-B was confirmed in 5 patients in urine (n=3) or drug samples (n=4).
Conclusion |
In this study, most 2C-B poisonings resulted in moderate toxicity even at high reported doses up to 192 mg. No severe cases were observed. The clinical course was usually short-lived (up to 24 hours) and typically involved hallucinations in addition to mild somatic effects.
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| Please see page 304 for the Editor’s Capsule Summary of this article. |
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| Supervising editor: Richard C. Dart, MD, PhD. Specific detailed information about possible conflict of interest for individual editors is available at editors. |
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| Author contributions: JJN-vL, AJHPvR, and LH designed the study. JJN-vL and LH were involved in the data collection and analysis. JJN-vL, DWdL, AJHPvR, and LH interpreted the data. RQV arranged the analyses of drug samples. DO arranged the analyses of blood and urine. JJN-vL wrote the first draft of the article, and all authors contributed substantially to its revision. All authors approved of and contributed to the final article. JJN-vL takes responsibility for the paper as a whole. |
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| All authors attest to meeting the four ICMJE.org authorship criteria: (1) Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; AND (2) Drafting the work or revising it critically for important intellectual content; AND (3) Final approval of the version to be published; AND (4) Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. |
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| Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org). The authors have stated that no such relationships exist. |
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| Trial registration number: 15-638/C |
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Vol 76 - N° 3
P. 303-317 - septembre 2020 Retour au numéro
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