Methamphetamine Toxicity Workup

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

Laboratory Studies

Laboratory studies should be selected on the basis of the patient's symptoms. Although hair and saliva analysis may be obtained, most toxicological monitoring or testing is performed with urine and blood samples. Studies to obtain may include the following:

  • Complete blood count (CBC) and chemistry panel - To assess renal and electrolyte function
  • Creatine kinase (CK) and/or myoglobin levels - To exclude rhabdomyolysis
  • Serial troponin levels - If there is concern for myocardial ischemia
  • B-type natriuretic peptide (BNP) level - If acute heart failure is suspected
  • Pregnancy test - In women of childbearing age
  • Toxicology screens - Useful for patients who cannot or will not disclose drug use history and for pediatric patients with new-onset seizure
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Imaging Studies

See the list below:

  • Order a chest radiograph for patients with pulmonary symptoms or chest trauma.
  • In patients with altered mental status, perform a head CT scan to exclude intracranial bleeding. Such bleeding may be the result of either methamphetamine-induced hypertension or associated head trauma.
  • Patients who are suspected body-packers, body-stuffers, or "parachuters" should undergo abdominal imaging; low-dose CT is considered state-of-the-art for this purpose [57]
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Other Tests

Obtain an electrocardiogram for patients with chest pain, altered mental status, and tachycardia.

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Procedures

Lumbar puncture may be indicated in patients with altered mental status to rule out meningitis or subarachnoid hemorrhage.

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