Amphetamines

Background

Amphetamine

MDMA

Mescaline

Desoxyn tablets – pharmaceutical methamphetamine hydrochloride

Crystal meth – illicit methamphetamine hydrochloride

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

Meth mouth

System	Minor or moderate overdose	Severe overdose
Cardiovascular	Cardiac dysrhythmia Hypertension or hypotension	Cardiogenic shock Cerebral hemorrhage Circulatory collapse
Central nervous system	Confusion Hyperreflexia Severe agitation Tremor	Acute amphetamine psychosis (e.g., delusions and paranoia) Compulsive and repetitive movement Serotonin syndrome Sympathomimetic toxidrome
Musculoskeletal	Myalgia	Rhabdomyolysis
Respiratory	Rapid breathing	Pulmonary edema Pulmonary hypertension Respiratory alkalosis
Urinary	Dysuria Urinary retention	Anuria Acute kidney injury
Other	Hyperthermia Mydriasis	Hyperkalemia or hypokalemia Hyperpyrexia Metabolic acidosis

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