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Young Woman's Death By Ingesting Exstasy

1074 words - 5 pages

In their case study, “Fatal hyponatremia in a young woman after ecstasy ingestion,” Kamyar Kalantar-Sadeh, Minhtri Nguyen, Roger Chang, and Ira Kurtz present a 20-year old female, Asian-American, college student who took multiple tablets of ecstasy and drank excessive amounts of water at a party. This student was found the next morning, unresponsive, foaming at the mouth, with rapid and shallow breathing, and a weak pulse. After being admitted into the emergency room, the patient was determined to be hypothermic, hypoxemic, hypotensive, tachycardic, and in respiratory distress. Initially, the patient had a sodium content of 117 mmol/l and a serum osmolality of 245 mOsm/kg. In order to ...view middle of the document...

If the cell has a lower concentration of non-penetrating solutes than the solution, the solution is hypertonic with water moving out of the cell.
In the case of the 20-year-old patient, due to ingestion of too much water, the cells in her body swelled. Both pulmonary edema, excessive fluid in the lungs, and cerebral edema, excessive fluid in the brain, were reported for this patient. Because the blood-brain barrier is freely permeable to water, the patient’s neurons most likely swelled, causing a buildup of intracranial pressure, which may have led to her coma. Further, the fact that the patient was found to be in respiratory distress supports the conclusion that water had built up in her lungs as well.
In the case study, two additional patients with low sodium concentration in their cells were also presented in order to serve as a comparison to the main case. The history of two Caucasian females, one 38 years of age and the other 24 years old were presented. The 38-year-old female drank 25,250mL bottles of water (6.25L total) whilst running a 64.4 km marathon. She suffered from confusion, headache, abdominal pain, nausea, vomiting, diarrhea, shortness of breath, as well as pulmonary venous edema. Initially, the patient had a sodium content of 121 mmol/l and a serum osmolality of 253 mOsm/kg. In order to treat the patient, a hypertonic saline, normal saline, and 40mg of intravenous furosemide, a diuretic, were administered after which her sodium content rose to of 125 mmol/l after 2.5 hours and 141 mmol/l after 48 hours with no acute damage to cells. The 24-year-old female underwent an appendectomy and received 5% dextrose infusion before and after the operation. After the surgery, she had a headache and shortness of breath. Initially, the patient had a sodium content of 119 mmol/l and a serum osmolality of 249 mOsm/kg. In order to treat the patient, a hypertonic saline and 40mg of intravenous furosemide were administered after which her sodium content rose to of 136 mmol/l after 24 hours with no acute damage.
In all three cases presented, the patient had hyponatremia and pulmonary edema. For both the MDMA user and marathon runner, drinking excessive amounts of water led...

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