Amphetamines
Background
- central action- increase release & decrease reuptak of dopamine & seratonin. Leads to euphoria & strength
- perif action- facilitate synaptic xmission @ spinal cord by unknown mech
- also cause release of norepi- leads to alpha & beta stim
Diagnosis
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
Treatment
Benzos
Theraputic Uses
- appetite suppression
- inc alertness
- narcolepsy
- adhd
- inc mood
- avoid boredom on repetitive task jobs
Types
General
- 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 amphet deriv may not show up on tox screen AKA Entactogens- enabling user to touch within
Meth Amphet
- more combative- delusions of parasites- formication\ self mutilate
- more dysphoric
- AKA ice crystal speed go crank
MDMA Ecstacy
- changes 5HT neuroxmitter
- inc dopamine
- lasts 3 - 5hrs
- usual dose for psychgTx- 50 - 200mg
- cardiac effects
- euphoria- interpersonal clgseness- introspection
- enhanced socialibility (rave)
- deep empathy
- severe withdrawal with anxiety and depression
- tolerance developes to positve and neg effects with inc use
Source
MISTRY 6/06