Test for Amphetamines Flashcards
Dextroamphetamine, methylphenidate, methamphetamine are FDA approved substances used for
ADHD and narcolepsy
short-term adjunctive therapy for
exogenous obesity
Sibutramine
Routes of exposure of Amphetamine toxicity
● Ingestion
● Smoking
● Injection
● Insufflation
Sympathomimetic symptoms of Amphetamine toxicity
● Tachycardia (High HR)
● Hypertension (High BP)
● Diaphoresis (excess
sweating)
● Hyperthermia (High body
temp.)
CNS effects of Amphetamine toxicity
● Anxiety
● Agitation
● Hallucinations
● Psychosis
Amphetamine may cause Death due to
● Hyperthermia
● Cardiac arrhythmias
● Intracerebral hemorrhage
Onset of symptoms of Amphetamines
minutes to several hours
Amphetamine Duration of Toxicity
May last for more than 24 hours
Amphetamine’s mechanism of toxicity works through excessively stimulating the _______________ and __________ and ___________
central and peripheral alpha- and beta-adrenergic
Amphetamine works thru _______ (direct/indirect) alpha agonism
direct
Amphetamine inhibits the endogenous ____________ reuptake
catecholamine
Amphetamine’s Neurotoxicity is caused by
oxidative stress, excitotoxicity, and
mitochondrial dysfunction
Other names for METHAMPHETAMINE
Shabu
Shabu is a CNS __________, avoid fatigue & increase productivity
Stimulant
Derivative of Shabu
Methylphenidate (Ritalin)
Shabu (Metamphenamine):
Sympathomimetic
○ CNS stimulation
○ Hypertension
○ Arrhythmias
○ Seizures
○ Bruxism
○ Hyperthermia
Shabu (Metamphenamine):
Treatment
○ Ammonium chloride
○ Chlorpromazine/
Haloperidol,
Diazepam
○ Alpha blockers, Beta
blockers (labetalol &
carvedilol), Sodium
nitroprusside
○ Propranolol,
Lidocaine, Diazepam,
Phenytoin
ECSTASY iupac name
MDMA
MDMA/Ecstasy is a _______
Hallucinogen
Serve as false NT →
Releases catecholamines
MDMA/Ecstasy
Stimulates alpha & beta
receptors (similar to
amphetamine)
MDMA/Ecstasy
Inhibits MAO
MDMA/Ecstasy
Tx for MDMA/Ecstasy Toxicity includes
Labetalol, Sodium
nitroprusside, or
Nifedipine
Available as simple spot-test (kit)
Marquis Test
Allows distinction between
amphetamine and its
ring-substituted analogues
Marquis Test
Formaldehyde and conc.
H2SO4 mixture; methanol
Marquis Test
T/F: (+) Color in Marquis Test is substance dependent
True
Test for Secondary amines (2º) e.g.,
methamphetamine and
secondary ring-substituted
amphetamines, including
Ecstasy (MDMA) and Eve
(MDEA
Simon’s Test
Must be supplemented by Marquis
as other 2º amines e.g.,
diethylamine and piperidine may
give similar colors
Simon’s Test
What are the 2º amines that give similar colors in Simon’s test
diethylamine and piperidine
Simon’s Test (+) color
Blue
○ Ephedrine
○ Pseudoephedrine
○ Norephedrine
○ Phenylpropanolamine
○ Methcathinone
Chen’s Test
Chen’s test is positive when
(+) Colored
Test for Methylenedioxy-substituted
aromatic compounds and Precursors containing the
methylenedioxy-substructure
Gallic Acid Test
Amphetamine is orange to brown at
Marquis (+)
Amphetamine shows no reaction to
Simon’s and Chen’s
Metamphetamine is Orange to Brown in
Marquis (+)
Methamphetamine is (+) in
Simon’s test
Methamphetamine shows no reaction in
Chen’s
MDMA and MDEA in Marqui’s Test
Dark Blue/Black
MDMA and MDEA in Simon’s
Positive
MDMA in Chen’s
NR
MDEA in Chen’s
Purple
What test do Ephedrine,
Pseudoephedrine,
Norephedrine show reaction to
+ Chen’s (Yellow/orange)
Cathinone and Methcaninone in Marquis and Simon’s
NR
Mescaline (1º
amine) in Marquis’ Test
Strong orange
LSD in Marquis Test
Olive black
Morphine in Marquis
Deep purplish Red
Cocaine in Marquis
NR
Uses antibodies to detect the presence of specific drugs or metabolites
IMMUNOASSAY
Large-scale screening through automation and
rapid detection
Y
● Most common met
T/F: Immunoassay can give false positive results for same clas
True
Standard for confirmatory testing
GCMS
It is the most accurate, sensitive, and reliable method of
testing
GCMS
If ingestion and patient presents
within 1 hour of ingestion
Gastric Lavage/Single-dose activated charcoal
Gastric Lavage/Single-dose activated charcoal for infants < 1 year
10-25 g
Gastric Lavage/Single-dose activated charcoal for infants to children 1-12 years
25-50g
Gastric Lavage/Single-dose activated charcoal for children > 12 years and adults
25 to 100g
For Agitation, anxiety and psychosis give
benzodiazepine
for Psychosis unresponsive to
benzodiazepine:
antipsychotics (haloperidol)
Pharmacologic Supportive Therapy for Hypertension
Benzodiazepines -> if unresponsive -> alpha-blocker, vasodilators, or
beta blockers
Pharmacologic Supportive Therapy for Hyperthermia
Rapid crystalloid infusion
Pharmacologic Supportive Therapy for Hypotension
Fluid Replacement
Pharmacologic Supportive Therapy for Seizures
1st line: Benzodiazepines
Additional agents: propofol,
phenobarbital
