Amphetamines

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

Sympathomimetics

Clinical Features

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
Urinary
Other

Differential Diagnosis

Sympathomimetics

Drugs of abuse

Management

See Also

  • Sympathomimetic Toxicity

References

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