Amphetamine toxicity: Experience with 127 cases

Derlet, Robert W.; Rice, Pamela L.; Horowitz, B. Zane; Lord, Reginald V.

doi:10.1016/0736-4679(89)90263-1

Cited by 134 publications

(68 citation statements)

References 26 publications

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“…Methamphetamine has been reported to cause a variety of medical conditions, including acute sympathomimetic overdose (e.g., hypertension, tachycardia, hyperthermia, rhabdomyolysis, agitation, seizures), [5][6][7] traumatic injuries, 2,3,8 suicidality, 2,3,9 psychosis, 3,10,11 skin infections, 12 acute coronary syndrome, 13-18 skin burns and chemical exposure (from methamphetamine laboratories), 19,20 intracranial hemorrhage and cerebrovascular accident, 21,22 withdrawal symptoms (e.g., fatigue, hypersomnia, anhedonia, anxiety, irritability, dysphoria), 23 and a variety of nonspecific stimulantrelated complaints (e.g., headaches, palpitations, anxiety, chest pain). 24 …”

Section: Discussionmentioning

confidence: 99%

“…2,3 It is unclear whether our population has a higher percentage of methamphetamine-related psychiatric problems, or if our methodology allowed for additional cases to be detected. Nonetheless, methamphetamine likely plays a significant role as one of many substances of abuse (i.e., alcohol, marijuana, and heroin) among the ''dual diagnosis'' patient population presenting acutely to the ED.…”

Section: 3mentioning

confidence: 99%

“…Cases that demonstrated methamphetamine-related disorders were reviewed from both hospital cases and the medical literature. Possible methamphetamine-related ED visits (MREDVs) presented from the medical literature included acute sympathomimetic overdose (e.g., hypertension, tachycardia, hyperthermia, rhabdomyolysis, agitation, seizures), [5][6][7] traumatic injuries, 2,3,8 suicidality, 2,3,9 psychosis, 3,10,11 skin infections, 12 acute coronary syndrome, [13][14][15][16][17][18] skin burns and chemical exposure (from methamphetamine laboratories), 19,20 intracranial hemorrhage and cerebrovascular accident, 21,22 withdrawal symptoms (e.g., fatigue, hypersomnia, anhedonia, anxiety, irritability, dysphoria), 23 and a variety of nonspecific stimulant-related complaints (e.g., headaches, palpitations, anxiety, headache, chest pain). 24 Unique aspects of methamphetamine pathophysiology and outward signs of abuse (e.g., bruxism, repetitive movements, etc.)…”

Section: Study Protocolmentioning

confidence: 99%

“…Although retrospective studies have attempted to evaluate the utilization of EDs for methamphetamine-related disorders, they have been limited by the difficulties of retrospectively determining an association between drug use and ED visits. 2,3 The goal of this study was to prospectively identify the utilization, associated diagnoses, and cost of methamphetamine-related care in an ED setting.…”

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confidence: 99%

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Methamphetamine‐related Emergency Department Utilization and Cost

Hendrickson

Cloutier

McConnell

2008

Academic Emergency Medicine

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Objective: To quantify the frequency, cost, and characteristics associated with emergency department (ED) visits that are related to methamphetamine use.Methods: This was a prospective observational study. The authors performed a training program for ED clinicians on the acute and chronic effects of methamphetamine and the signs of methamphetamine abuse. A standardized two question survey was administered to clinicians concerning the relationship between the ED visit and the patient's methamphetamine use. The survey was embedded in the patient tracking system and was required for all ED patients before disposition. Survey results were merged with administrative data on demographics, diagnosis, disposition, and charges. Univariate analyses were used to determine patient characteristics associated with methamphetamine-related ED visits. Results:The authors examined 15,038 ED visits over a 20-week period from February 2006 to June 2006. There were a total of 353 methamphetamine-related visits, for an average of 17.65 visits per week (2.4% of all visits). Hospital charges for methamphetamine-related ED visits averaged $133,181 per week, for an estimated total of $6.9 M in annual charges. Methamphetamine-related ED patients were more likely to be male (odds ratio [OR] 1.6, 95% confidence interval [CI] = 1.30 to 2.01), white (OR 1.8, 95% CI = 1.38 to 2.29), and uninsured (OR 3.2, 95% CI = 2.21 to 4.69). The top four medical conditions associated with methamphetamine-related visits were mental health (18.7%), trauma (18.4%), skin infections (11.1%), and dental diagnoses (9.6%).Conclusions: Methamphetamine abuse accounts for a modest but substantial proportion of ED utilization and hospital cost. Methamphetamine-related ED visits are most commonly related to mental illness, trauma, skin, and dental-related problems.ACADEMIC EMERGENCY MEDICINE 2008; 15:23-31 ª

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Section: Discussionmentioning

confidence: 99%

Section: 3mentioning

confidence: 99%

Section: Study Protocolmentioning

confidence: 99%

mentioning

confidence: 99%

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Methamphetamine‐related Emergency Department Utilization and Cost

Hendrickson

Cloutier

McConnell

2008

Academic Emergency Medicine

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“…However, experienced METH users can typically consume gram quantities of drug per day (Kramer et al, 1967) and achieve peak blood concentrations of 100 μM (Derlet et al, 1989;Baselt, 2002;Peters et al, 2003). METH's high bioavailability, low protein binding, and long half life contribute to its achieving high micromolar plasma concentrations (Drummer, 2001;Baselt, 2002;Peters et al, 2003).…”

Section: Pharmacology Of the Vertebrate Trace Amine-associated Receptorsmentioning

confidence: 99%

Trace amine-associated receptor 1—Family archetype or iconoclast?

Grandy

2007

Pharmacology & Therapeutics

176

211

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Interest has recently been rekindled in receptors that are activated by low molecular weight, noncatecholic, biogenic amines that are typically found as trace constituents of various vertebrate and invertebrate tissues and fluids. The timing of this resurgent focus on receptors activated by the 'trace amines' (TAs) β-phenylethylamine (PEA), tyramine (TYR), octopamine (OCT), synephrine (SYN), and tryptamine (TRYP) is the direct result of two publications that appeared in 2001 describing the cloning of a novel G protein-coupled receptor (GPCR) referred to by their discoverers as TA1 (Borowsky et al., 2001) and TAR1 (Bunzow et al., 2001). When heterologously expressed in Xenopus laevis oocytes and various eukaryotic cell lines recombinant rodent and human TA receptors dosedependently couple to the stimulation of cAMP production. Structure-activity profiling based on this functional response has revealed that in addition to the TAs, other biologically active compounds containing a 2 carbon aliphatic side chain linking an amino group to at least one benzene ring are potent and efficacious TA receptor agonists with amphetamine, methamphetamine, 3-iodothyronamine, thyronamine, and dopamine among the most notable. Almost 100 years after the search for TA receptors began numerous TA1/TAR1-related sequences, now called Trace AmineAssociated Receptors (TAARs), have been identified in the genome of every species of vertebrate examined to date. Consequently, even though heterologously expressed TAAR1 fits the pharmacological criteria established for a bona fide TA receptor a major challenge for those working in the field is to discern the in vivo pharmacology and physiology of each purported member of this extended family of GPCRs. Only then will it be possible to establish whether TAAR1 is the family archetype or an iconoclast.

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Addictive Disorders in Cardiovascular Medicine

Gradman

Javed

2010

Addictive Disorders in Medical Populations

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Amphetamine toxicity: Experience with 127 cases

Cited by 134 publications

References 26 publications

Methamphetamine‐related Emergency Department Utilization and Cost

Methamphetamine‐related Emergency Department Utilization and Cost

Trace amine-associated receptor 1—Family archetype or iconoclast?

Addictive Disorders in Cardiovascular Medicine

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