RT Book, Section
A1 Smollin, Craig
A2 Papadakis, Maxine A.
A2 McPhee, Stephen J.
A2 Rabow, Michael W.
A2 McQuaid, Kenneth R.
SR Print(0)
ID 1193161538
T1 Amphetamines & Cocaine Overdose
T2 Current Medical Diagnosis & Treatment 2023
YR 2023
FD 2023
PB McGraw-Hill Education
PP New York, NY
SN 9781264687343
LK accessmedicine.mhmedical.com/content.aspx?aid=1193161538
RD 2024/04/18
AB Amphetamines  and  cocaine  are  widely  used  for  their  euphorigenic  and  stimulant  properties.  Both  drugs  may  be  smoked,  snorted,  ingested,  or  injected.  Amphetamines  and  cocaine  produce  CNS  stimulation  and  a  generalized  increase  in  central  and  peripheral  sympathetic  activity.  The  toxic  dose  of  each  drug  is  highly  variable  and  depends  on  the  route  of  administration  and  individual  tolerance.  The  onset  of  effects  is  most  rapid  after  intravenous  injection  or  smoking.  Amphetamine  derivatives  and  related  drugs  include  methamphetamine  (“crystal  meth,”  “crank”),  MDMA  (“ecstasy”),  ephedrine  (“herbal  ecstasy”),  and  methcathinone  (“cat”  or  “khat”).  Methcathinone  derivatives  and  related  synthetic  chemicals  such  as  methylenedioxypyrovalerone  (MDPV)  have  become  popular  drugs  of  abuse  and  are  often  sold  as  purported  “bath  salts.”  Amphetamine-like  reactions  have  also  been  reported  after  use  of  synthetic  cannabinoids  (eg,  “Spice”  and  “K2”).  Nonprescription  medications  and  nutritional  supplements  may  contain  stimulant  or  sympathomimetic  drugs  such  as  ephedrine,  yohimbine,  or  caffeine  (see  also  Theophylline  &  Caffeine  section).  Increasingly,  amphetamines  and  cocaine  may  be  adulterated  with  fentanyl  or  fentanyl  analogs  resulting  in  unexpected  coma,  respiratory  depression,  and  death  (see  also  opioids  section).