Amphetamine derivatives poisoning

T43.6 + (X41.99/X61.99/Y11.99)

DESCRIPTION

These include:

  • “Ecstasy”: 3,4-methylenedioxymethamphetamine (MDMA).
  • “Ice” and “Eve”: 3,4-methylenedioxy-N-ethylamphetamine (MDEA).
  • “Tik”: Methamphetamine.

Drug effects are due to the increased release of noradrenaline, dopamine and serotonin in the CNS. Patients present with:

  • hyperthermia, especially with MDMA,
  • tachycardia,
  • hypertension,
  • angina pectoris and myocardial infarction,
  • stroke,
  • hyperactivity,
  • sweating
  • dilated pupils
  • teeth grinding
  • delirium,
  • tremors,
  • seizures and coma.

Additional complications include:

  • rhabdomyolysis,
  • hyperkalaemia,
  • acute tubular necrosis,
  • hyponatraemia,
  • dehydration.

GENERAL MEASURES

Supportive management aims to maintain stable cardiorespiratory function.
Manage hyperthermia, hypoglycaemia, dehydration, and electrolyte abnormalities.

MEDICINE TREATMENT

For seizures: R56.8 + (T43.6/X41.99/X61.99/Y11.99)

Treat with benzodiazepines - see Status epilepticus .

Note: Phenytoin should be avoided (due to potential cardiotoxicity).

LoEIII [52]

Severe hypertension:

See Hypertension, severe .

Haemodialysis may be required for acute renal failure.