SYNTHETIC STIMULANT DRUG POISONING: EMERGENCY ROOM MANAGEMENT

Introduction: Synthetic stimulants, including amphetamine derivatives, cathinones, and novel psychoactive substances, represent an expanding challenge in emergency medicine due to their unpredictable toxicological profiles. Their widespread recreational use has led to an increase in emergency department visits, where presentations are often complex, involving cardiovascular, neurological, and psychiatric manifestations. This growing burden requires the medical community to adopt evidence-based strategies for rapid diagnosis and effective intervention. Objective: The aim of this review is to synthesize current knowledge on the emergency management of synthetic stimulant poisoning, with emphasis on pathophysiological mechanisms, clinical features, and therapeutic approaches. Secondary objectives include highlighting diagnostic challenges, addressing complications, and discussing future research needs. Methods: A narrative review was conducted by searching PubMed, Scopus, Web of Science, Cochrane Library, and Google Scholar for publications in the last five years. Keywords included "synthetic stimulants," "novel psychoactive substances," "amphetamine toxicity," and "emergency management." Both clinical and experimental studies were reviewed. Results and Discussion: The findings emphasize the heterogeneity of presentations in stimulant poisoning, ranging from mild agitation to life-threatening arrhythmias and hyperthermia. Emergency management requires rapid stabilization of airway, breathing, and circulation, aggressive temperature control, and judicious use of benzodiazepines and supportive measures. Cardiovascular monitoring is crucial, particularly in patients with underlying vulnerabilities. Multidisciplinary approaches, including toxicology consultation, psychiatry, and intensive care, enhance outcomes. Conclusion: Synthetic stimulant poisoning represents a dynamic and evolving challenge in emergency medicine. Clinicians must remain updated on emerging substances, implement standardized acute care protocols, and recognize complications early. Future research should refine management strategies and explore targeted antidotes.