Amphetamines: Difference between revisions
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==Background== | |||
[[File:Amphetamine.png|thumbnail|Amphetamine]] | [[File:Amphetamine.png|thumbnail|Amphetamine]] | ||
[[File:MDMA.png|thumbnail|MDMA]] | [[File:MDMA.png|thumbnail|MDMA]] | ||
[[File:Mescaline.png|thumbnail|Mescaline]] | [[File:Mescaline.png|thumbnail|Mescaline]] | ||
*Class of xenobiotics (Substituted amphetamines) based on a common central structure (ethylamine group attached to a phenol ring) | *Class of xenobiotics (Substituted amphetamines) based on a common central structure (ethylamine group attached to a phenol ring) | ||
**All have mixed serotonergic and dopaminergic activity | **All have mixed serotonergic and dopaminergic activity | ||
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*[[Hyponatremia]] | *[[Hyponatremia]] | ||
== | ==Clinical Features== | ||
===Alpha=== | ===Alpha=== | ||
*pupils dilate | *pupils dilate | ||
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==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Sympathomimetic types}} | {{Sympathomimetic types}} | ||
==Evaluation== | |||
==Management== | ==Management== | ||
*[[Benzodiazepines]] | *[[Benzodiazepines]] | ||
==Disposition== | |||
==See Also== | ==See Also== | ||
Revision as of 02:53, 6 September 2019
Background
- Class of xenobiotics (Substituted amphetamines) based on a common central structure (ethylamine group attached to a phenol ring)
- All have mixed serotonergic and dopaminergic activity
- Unlike cocaine, duration of action may be 12hr or longer
- Time- oral- 30min, inhaled instant
- hepatic and renal excretion- lasts 6- 24 hrs
- if tolerance developes- physical exam may yield normal findings
- desipramine and amantadine can give false positive for urine amphet test
- hallucinogenic amphetamine derivatives may not show up on tox screen AKA Entactogens- enabling user to touch within
Methamphetamine
- More combative
- Delusions of parasites, formication, self-mutilate
- more dysphoric
MDMA Ecstacy
- Increases serotonin, dopamine
- Lasts 3 - 5hrs
- Hyponatremia
Clinical Features
Alpha
- pupils dilate
- sweat
- decrease gi peristalsis
- constrict blood vessels
Beta
- increase HR and contractility
- dilate bronchi
- dilate muscle beds
Mixed
- delusions, paranoia, aggression, poor judgement, hallucinate, confusion
Differential Diagnosis
Sympathomimetics
- Cocaine
- Amphetamines
- Synthetic cathinones (khat)
- Ketamine
- Ecstasy (MDMA)
- Synthetic cannabinoids
- Bath salts