Learning objectives
- Diagnose and treat methamphetamine toxicity or overdose
Definition and mechanisms
- Methamphetamine is a highly addictive psychostimulant drug that is a derivative of amphetamine and may be snorted, ingested, injected, or smoked
- Methamphetamine hydrochloride is FDA-approved for the long-term treatment of ADHD and the short-term treatment of exogenous obesity
- Methamphetamine promotes the release of the monoamine neurotransmitters dopamine, serotonin, and norepinephrine within central and peripheral nerve endings
- It also blocks the reuptake of dopamine similar to cocaine
- As a result, the drug produces euphoria and stimulant effects similar to cocaine
- Oral administration: peak concentrations are observed within 2-4 hours
- Snorting, smoking, and injection: peak concentrations occur within minutes
Signs and symptoms
- Euphoria
- Tachycardia
- Hypertension
- Sweating
- Restlessness
- Dry mouth
- Elevated body temperature
- Agitation
- Chest pain
- Coma or unresponsiveness (in extreme cases)
- Heart attack
- Irregular or stopped heartbeat
- Difficulty breathing
- Kidney damage and possibly kidney failure
- Paranoia
- Seizures
- Severe stomach pain
- Stroke
Complications
- Intracranial hemorrhage
- Seizures
- Ischemic stroke
- Coma
- Heart failure
- Arrhythmias
- Delusional behavior
- Extreme paranoia
- Major mood swings
- Insomnia (severe inability to sleep)
- Missing and rotted teeth (called “meth mouth”)
- Repeated infections
- Severe weight loss
- Abscesses or boils
Management
Suggested reading
- Richards JR, Laurin EG. Methamphetamine Toxicity. In: StatPearls. Treasure Island (FL): StatPearls Publishing; October 10, 2022
- Dignam, G., Bigham, C., 2017. Novel psychoactive substances: a practical approach to dealing with toxicity from legal highs. BJA Education 17, 172–177.
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