Amphetamines: Difference between revisions

 
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[[File:MDMA.png|thumbnail|MDMA]]
[[File:MDMA.png|thumbnail|MDMA]]
[[File:Mescaline.png|thumbnail|Mescaline]]
[[File:Mescaline.png|thumbnail|Mescaline]]
[[File:Desoxyn (methamphetamine) 5 mg tablets.jpg|thumb|Desoxyn tablets – pharmaceutical methamphetamine hydrochloride]]
[[File:Blue Crystal Meth.jpg|thumb|Crystal meth – illicit methamphetamine hydrochloride]]
*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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*Lasts 3 - 5hrs
*Lasts 3 - 5hrs
*[[Hyponatremia]]
*[[Hyponatremia]]
{{Sympathomimetic types}}


==Clinical Features==
==Clinical Features==
[[File:Suspectedmethmouth09-19-05.jpg|thumb|Meth mouth]]
{| class="wikitable"
{| class="wikitable"
|-
|-
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* [[Urinary retention]]
* [[Urinary retention]]
|
|
* [[Anuria]]
* Anuria
* [[Kidney failure]]
* [[Acute kidney injury]]
|-
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! scope="row"| Other
! scope="row"| Other

Latest revision as of 22:01, 26 November 2020

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

Methamphetamine

  • More combative
  • Delusions of parasites, formication, self-mutilate
  • more dysphoric

MDMA Ecstacy

Sympathomimetics

Clinical Features

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
Musculoskeletal
  • Myalgia
  • Rhabdomyolysis
Respiratory
  • Rapid breathing
Urinary
Other

Differential Diagnosis

Sympathomimetics

Drugs of abuse

Evaluation

Management

Disposition

See Also

References