eMedicine Specialties > Emergency Medicine > Toxicology

Toxicity, Methamphetamine: Follow-up

Author: Robert W Derlet, MD, Professor of Emergency Medicine, University of California at Davis School of Medicine; Chief Emeritus, Emergency Department, University of California at Davis Health System
Coauthor(s): Timothy E Albertson, MD, MPH, PhD, Professor of Pharmacology and Toxicology, Division Chief and Professor of Medicine, Division of Pulmonary and Critical Care Medicine, Vice-Chair, Department of Internal Medicine, University of California, Davis, School of Medicine; Professor of Anesthesiology, Associate Dean, Academic Clinical Programs, University of California, Davis Health System; Professor of Emergency Medicine and Clinical Toxicology, Davis Medical Center; Chief of Pulmonary and Critical Care, Veterans Affairs, Northern California Health Care System; Medical Director of Poison Control System, University of California at San Francisco, School of Pharmacy.; John R Richards, MD, FAAEM, Professor of Emergency Medicine, University of California at Davis School of Medicine
Contributor Information and Disclosures

Updated: Dec 4, 2009

Follow-up

Further Inpatient Care

  • Critical care management may be needed for patients with persistent hypertension, severe rhabdomyolysis, seizures, stroke, coma, hyperthermia, CHF, or acute coronary ischemic syndrome.

Further Outpatient Care

  • Referral to drug treatment center and/or psychiatrist may be indicated

Deterrence/Prevention

  • Methamphetamine addiction is notoriously difficult to treat successfully, as it is difficult to remove the patient from the subculture involved in the production, distribution, and abuse of the drug.

Complications

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

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
  • Failure to consider other cause of altered mental status which may be concomitant with methamphetamine use

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.53
  • 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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Further Reading

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Keywords

amphetamine, meth toxicity, methamphetamine abuse, signs of methamphetamine use, ice, crystal meth, meth overdose, methamphetamine poisoning, meth side effects, methamphetamine use, stimulant, euphoria, methamphetamine intoxication, speedballing

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Contributor Information and Disclosures

Author

Robert W Derlet, MD, Professor of Emergency Medicine, University of California at Davis School of Medicine; Chief Emeritus, Emergency Department, University of California at Davis Health System
Robert W Derlet, MD is a member of the following medical societies: American Academy of Emergency Medicine, American Association for the Advancement of Science, Infectious Diseases Society of America, Society for Academic Emergency Medicine, and Wilderness Medical Society
Disclosure: Nothing to disclose.

Coauthor(s)

Timothy E Albertson, MD, MPH, PhD, Professor of Pharmacology and Toxicology, Division Chief and Professor of Medicine, Division of Pulmonary and Critical Care Medicine, Vice-Chair, Department of Internal Medicine, University of California, Davis, School of Medicine; Professor of Anesthesiology, Associate Dean, Academic Clinical Programs, University of California, Davis Health System; Professor of Emergency Medicine and Clinical Toxicology, Davis Medical Center; Chief of Pulmonary and Critical Care, Veterans Affairs, Northern California Health Care System; Medical Director of Poison Control System, University of California at San Francisco, School of Pharmacy.
Timothy E Albertson, MD, MPH, PhD is a member of the following medical societies: American College of Chest Physicians and Sigma Xi
Disclosure: Nothing to disclose.

John R Richards, MD, FAAEM, Professor of Emergency Medicine, University of California at Davis School of Medicine
John R Richards, MD, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Medical Editor

Edward A Michelson, MD, Program Director, Associate Professor, Department of Emergency Medicine, University Hospital Health Systems in Cleveland
Edward A Michelson, MD is a member of the following medical societies: American College of Emergency Physicians, National Association of EMS Physicians, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

John T VanDeVoort, PharmD, Regional Director of Pharmacy, Sacred Heart & St. Joseph's Hospitals
John T VanDeVoort, PharmD is a member of the following medical societies: American Society of Health-System Pharmacists
Disclosure: Nothing to disclose.

Managing Editor

Fred Harchelroad, MD, FACMT, FAAEM, FACEP, Chair, Department of Emergency Medicine, Director of Medical Toxicology - Allegheny General Hospital, Associate Professor, Department of Emergency Medicine, Drexel University College of Medicine
Disclosure: Nothing to disclose.

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Asim Tarabar, MD, Assistant Professor, Director, Medical Toxicology, Department of Emergency Medicine, Yale University School of Medicine; Consulting Staff, Department of Emergency Medicine, Yale-New Haven Hospital
Disclosure: Nothing to disclose.

 
 
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