Amphetamines: Difference between revisions
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Revision as of 21:53, 21 July 2016
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
Evaluation
Alpha
- pupils dilate
- sweat
- decrease gi peristalsis
- constrict blood vessels
Beta
- inc 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