Methamphetamine Toxicity Medication

Updated: Dec 19, 2016
  • Author: John R Richards, MD, FAAEM; Chief Editor: Jeter (Jay) Pritchard Taylor, III, MD  more...
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Medication

Medication Summary

The goals of pharmacotherapy are to reduce the toxic effects of the drug, reduce morbidity, and prevent complications. Treatment measures may include gastrointestinal decontamination, sedation, seizure control, and control of catecholamine-induced hypertension and tachycardia.

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GI decontaminant

Class Summary

Empirically used to minimize systemic absorption of the toxin.

Polyethylene glycol (PEG) solution

Laxative with strong electrolyte and osmotic effects. Cathartic actions in GI tract. May be indicated in treatment of methamphetamine ingestion in people who carry methamphetamine packages in their body. Must administer after activated charcoal. Liquid reconstituted per package instructions.

Activated charcoal (Liqui-Char)

A form of carbon processed to be riddled with small, low-volume pores that increase the surface area available for adsorption or chemical reactions. Due to its high degree of microporosity, one gram of activated charcoal has a surface area in excess of 500 square meters, and further chemical treatment often enhances adsorption properties.

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Sedatives

Class Summary

Neuroleptic agents are CNS dopamine antagonists that are useful for control of agitated patients. By increasing the action of GABA, which is a major inhibitory neurotransmitter in the brain, benzodiazepines depress all levels of CNS, including limbic and reticular formation. Haloperidol and droperidol are D2 receptor antagonists that interfere with dopaminergic neurotransmission in the limbic system and the cerebral cortex.

Lorazepam (Ativan)

Benzodiazepine. GABA receptor agonist.

Diazepam (Valium)

Benzodiazepine. GABA receptor agonist.

Midazolam (Versed)

Benzodiazepine. GABA receptor agonist.

Haloperidol (Haldol)

CNS dopamine D2 receptor antagonist.

Droperidol (Inapsine)

CNS dopamine D2 receptor antagonist.

Olanzapine (Zyprexa, Zydis)

The exact mechanism of action of olanzapine is not known. It binds to alpha-1, dopamine, histamine H-1, muscarinic, and serotonin type 2 (5-HT2) receptors.

Ziprasidone (Geodon)

Dopamine and serotonin receptor antagonist. It also inhibits the re-uptake of serotonin and norepinephrine in the CNS.

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Cardiovascular Agents

Class Summary

Used to control catecholamine-induced hypertension and tachycardia.

Labetalol (Normodyne, Trandate)

Blocks beta1-, alpha-, and beta2-adrenergic receptor sites, decreasing blood pressure. When given IV, acts primarily as a beta-receptor antagonist.

Metoprolol (Lopressor, Toprol)

Blocks beta1-adrenergic receptor sites, decreasing heart rate.

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