Amphetamines

Amphetamine
MDMA
Mescaline

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

Evaluation

Alpha

  • pupils dilate
  • sweat
  • decrease gi peristalsis
  • constrict blood vessels

Beta

  • increase HR and contractility
  • dilate bronchi
  • dilate muscle beds

Mixed

  • delusions, paranoia, aggression, poor judgement, hallucinate, confusion

Differential Diagnosis

Sympathomimetics

Management

See Also

References