methamphetamine
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Pharmacokinetics
- metabolized in liver by cyt P450 2D6 to largely inactive metabolites
- metabolites excreted by the kidney
- elmination 1/2life 10-12 hours
- can accumulate in the brain at levels 10x those in plasma[9]
elimination via liver
Adverse effects
- psychiatric
- neurologic
- convulsions
- stroke
- selective injury to the striatum
- metabolic
- pulmonary
- cardiovascular
- hypertension
- tachycardia, arrhythmia
- acute coronary syndrome
- aneurysm, aortic dissection
- cardiomyopathy, heart failure[8]
- improvement seen only upon drug cessation[6]
- renal
- eyes: mydriasis
- white matter changes seem in infants exposed to methamphetamine & tobacco in utero[5]
- withdrawal after discontinuation[7]
- drug adverse effects of ADHD medications
- drug adverse effects of analeptics
- drug adverse effects of psychotropic agents
- drug adverse effects of sympathomimetic(s)
Drug interactions
- any pharmaceutical agent that inhibits cyt P450 2D6 may increase methamphetamine levels
Laboratory
- methamphetamine in specimen
Mechanism of action
Notes
- In methamphetamine laboratories:[3]
- respiratory injuries caused by phosphine gas
More general terms
Additional terms
References
- ↑ Clinical Guide to Laboratory Tests, 3rd ed. Teitz ed., W.B. Saunders, 1995
- ↑ Prescriber's Letter 13(3): 2006 Cytochrome P450 drug interactions Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=220233&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 3.0 3.1 3.2 Lineberry TW & Bostwick JM Methamphetamine abuse: a perfect storm of complications Mayo Clin Proc 2006; 81:77
- ↑ 4.0 4.1 Briere FN et al Prospective associations between meth/amphetamine (speed) and MDMA (ecstasy) use and depressive symptoms in secondary school students J Epidemiol Community Health doi:10.1136/jech-2011-200706 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22516739 <Internet> http://jech.bmj.com/content/early/2012/04/12/jech-2011-200706.abstract
- ↑ 5.0 5.1 Chang L, Oishi K, Skranes J et al. Sex-specific alterations of white matter developmental trajectories in infants with prenatal exposure to methamphetamine and tobacco. JAMA Psychiatry 2016 Nov 9; PMID: https://www.ncbi.nlm.nih.gov/pubmed/27829078
Roos A, Donald KA. Refining the understanding of the effects of prenatal methamphetamine and tobacco exposure on the developing brain. JAMA Psychiatry 2016 Nov 9 PMID: https://www.ncbi.nlm.nih.gov/pubmed/27829080 - ↑ 6.0 6.1 Schurer S, Klingel K, Sandri M et al Clinical Characteristics, Histopathological Features, and Clinical Outcome of Methamphetamine-Associated Cardiomyopathy. JACC: Heart Failure. Volume 5, Issue 6, June 2017 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28571597 <Internet> http://www.heartfailure.onlinejacc.org/content/5/6/435
Ahmad T, Schroder JN, Januzzi JL Jr. Breaking Bad. The Heartbreak of Drug Abuse. JACC: Heart Failure. Volume 5, Issue 6, June 2017 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28571598 <Internet> http://www.heartfailure.onlinejacc.org/content/5/6/446 - ↑ 7.0 7.1 Birath JB, Briones M, Amaya S et al. Ibudilast may improve attention during early abstinence from methamphetamine. Drug Alcohol Depend 2017 Jun 23; 178:386. PMID: https://www.ncbi.nlm.nih.gov/pubmed/2870476
- ↑ 8.0 8.1 Manja V, Nrusimha A, Gao Y et al Methamphetamine-associated heart failure: a systematic review of observational studies. Heart. 2022 Dec 1;heartjnl-2022-321610. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36456204 https://heart.bmj.com/content/early/2022/11/15/heartjnl-2022-321610
- ↑ 9.0 9.1 Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022
Database
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=1206
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=10836
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=36604
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=66124
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=9306