eMedicine Specialties > Emergency Medicine > Toxicology
Toxicity, Methamphetamine: Follow-up
Updated: Jul 10, 2008
Follow-up
Further Inpatient Care
- Critical care management may be needed for patients with persistent hypertension and those who develop severe rhabdomyolysis, seizures, stroke, coma, hyperthermia, or acute coronary ischemic syndrome.
Further Outpatient Care
- Referral to drug treatment center
Complications
- Rhabdomyolysis
- Seizures
- Stroke
- Coma
- Acute coronary ischemia
- Ventricular arrhythmias
- Psychosis
- Death
- Patients who use methamphetamine IV are at risk for HIV, hepatitis B, hepatitis C, and other infectious diseases associated with IV street drug use.
Prognosis
- Prognosis is generally good with rapid and appropriate treatment, assuming that the patient does not present with one of the above complications.
Patient Education
- For excellent patient education resources, visit eMedicine's Poisoning - First Aid and Emergency Center, Mental Health and Behavior Center, and Substance Abuse Center. Also, see eMedicine's patient education articles Drug Dependence & Abuse, Substance Abuse, Poisoning, Club Drugs, and Activated Charcoal.
- For more information, see Medscape's Addiction Resource Center.
Miscellaneous
Medicolegal Pitfalls
- Failure to diagnose and treat patients with methamphetamine toxicity if they have hyperthermia or rhabdomyolysis
- Failure to obtain a head CT scan in patients with methamphetamine toxicity who present with mental status changes that do not normalize with pharmacologic treatment; thus, failing to diagnose an intracerebral hemorrhage
- Failure to diagnose myocardial infarction or unstable angina in methamphetamine-intoxicated patients
Special Concerns
- Consider the possibility of methamphetamine or amphetamine toxicity in children who present with first-time seizures; several studies have noted amphetamine-positive drug screens in this patient population.
- Healthcare personnel should be aware regarding blood-borne exposure and risk of HIV, hepatitis B, and hepatitis C.
More on Toxicity, Methamphetamine |
| Overview: Toxicity, Methamphetamine |
| Differential Diagnoses & Workup: Toxicity, Methamphetamine |
| Treatment & Medication: Toxicity, Methamphetamine |
Follow-up: Toxicity, Methamphetamine |
| References |
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References
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Further Reading
Keywords
amphetamine, ice, crystal, meth, crystal meth, methamphetamine use, stimulant, euphoria, methamphetamine-intoxication, speedballing, myocardial infarction, palpitations, agitation, anxiety, hallucinations, amphetamine-induced seizures, emotional lability, confusion, paranoia, suicidal ideation, delusions, despondent affect, drug-induced psychosis, acute toxic psychosis, methamphetamine-induced seizures, hyperthermia, coma,musclehyperactivity, metabolic acidosis, secondary rhabdomyolysis, renal failure, shock, lichenoid drug eruption, tachycardia, hypertension, atrial arrhythmias, ventriculararrhythmias, myocardial ischemia, atherosclerosis, severe orthostatic hypotension, acute cardiomyopathy, chronic cardiomyopathy, cardiac toxicity, amphetamine-induced hypertension, necrotizing angiitis, arterial aneurysms, arterial sacculations, acute aorticdissections, bacterial endocarditis, fungal endocarditis, abnormal cardiac valves, secondary dilated cardiomyopathy, septic embolism, mycotic aneurysm, seizures, psychosis, choreoathetoid movement disorders, cerebrovascular accidents,cerebral edema, cerebralvasculitis, coma, clonus, respiratory failure, spontaneous cerebral hemorrhaging, amphetamine-induced cerebral vasculitis, cerebral artery spasm, cerebral artery occlusion, ischemic strokes, transient cortical blindness, pneumomediastinum, pneumothorax, pneumopericardium, acute noncardiogenic pulmonary edema, pulmonary hypertension, hypoxemia, rhabdomyolysis, cardiovascular shock, acute tubular necrosis, renal necrotizing angiitis, amphetamine-induced acute interstitial nephritis, hepatocellular damage, giant GI ulcers, ischemic colitis, smoking methamphetamine HCl powder
Follow-up: Toxicity, Methamphetamine