Amphetamine Toxicity Follow-up

Updated: Dec 16, 2016
  • Author: Neal Handly, MD, MS, MSc; Chief Editor: Jeter (Jay) Pritchard Taylor, III, MD  more...
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Follow-up

Further Outpatient Care

Patients may need referral for outpatient detoxification centers or for management of addictive behaviors.

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Further Inpatient Care

Admission is appropriate for monitoring and treatment of the following severe sequelae of amphetamine use:

  • Unstable vital signs (eg, hypertension, hyperthermia) and tachycardia or other dysrhythmias
  • Chest pain, to rule out myocardial infarct
  • Respiratory distress, pulmonary edema
  • Neurologic and neurosurgical complications, status epilepticus, coma, and cerebral hemorrhage or ischemic stroke
  • Psychiatric intervention for persistent toxic psychosis or drug detoxification program entry
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Transfer

A patient with stable vital signs who exhibits paranoid psychosis and has no evidence of cardiac, cerebral, renal, hepatic, or pulmonary complications of amphetamine use may need to be transferred to a psychiatric hospital for observation and treatment.

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Complications

See the list below:

  • Hyperthermia accompanies and complicates significant amphetamine intoxication.
  • Liver damage apparently is linked to elevated body temperature and consumption of reduced glutathione in metabolism of amphetamines.
  • Because amphetamines often are synthesized in poorly controlled settings, individuals with amphetamine intoxication may experience concomitant toxic exposures.
  • Lead, other metals, organic solvents, and precursor molecules all have been found in amphetamine samples and blood of individuals with amphetamine toxicity.
  • Treat rhabdomyolysis with generous intravenous fluids alkalinized with sodium bicarbonate, control of agitation, and temperature normalization.
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Prognosis

Patients without signs or symptoms of end-organ failure or infections may do well with sedation and reassurance. No established modalities exist for treatment of amphetamine addiction.

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Patient Education

Educate patients on the toxic effects of amphetamines and that amphetamines are not a safe alternative to cocaine use. For patient education information, see the First Aid and Injuries Center and Mental Health Center, as well as Drug Dependence & Abuse, Poisoning, Club Drugs, Activated Charcoal, and Substance Abuse.

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