Nurses Compass
Drug Guide
Methamphetamine Hydrochloride
Classification
Therapeutic: Central Nervous System Stimulant
Pharmacological: Sympathomimetic amine
FDA Approved Indications
- ADHD in children and adults
- Narcolepsy
Mechanism of Action
Methamphetamine increases the release and blocks the reuptake of dopamine, norepinephrine, and serotonin in the central nervous system, leading to increased alertness, focus, and euphoria.
Dosage and Administration
Adult: 10-25 mg per day divided into 2-3 doses; maximum 60 mg/day
Pediatric: Not approved for children under 6; for children 6-12, doses are individualized based on response and tolerability
Geriatric: Use with caution due to cardiovascular risks
Renal Impairment: Adjust dose based on clinical response and tolerability
Hepatic Impairment: Use with caution; no specific adjustments established
Pharmacokinetics
Absorption: Well absorbed orally
Distribution: Crosses the blood-brain barrier and placental barrier
Metabolism: Primarily metabolized in the liver via CYP2D6
Excretion: Renal, in unchanged form and as metabolites
Half Life: 10-12 hours, varies with individual
Contraindications
- History of hypersensitivity to methamphetamine or other sympathomimetics
- Severe agitation, cardiovascular disease, advanced arteriosclerosis
- Use with MAO inhibitors within 14 days
Precautions
- History of substance abuse, psychiatric disorders, hypertension, tachyarrhythmias, or history of seizures
Adverse Reactions - Common
- Dry mouth (Common)
- Anxiety (Common)
- Insomnia (Common)
- Increased heart rate (Common)
- Weight loss (Common)
Adverse Reactions - Serious
- Cardiovascular events (e.g., hypertension, arrhythmias, stroke) (Serious but less common)
- Psychosis or paranoia (Less common)
- Seizures (Rare)
Drug-Drug Interactions
- Monoamine oxidase inhibitors (risk of hypertensive crisis)
- Other CNS stimulants (additive effects)
- SSRIs and SNRIs (risk of serotonin syndrome)
Drug-Food Interactions
N/ADrug-Herb Interactions
N/ANursing Implications
Assessment: Monitor mental status, cardiac vital signs, growth in pediatric patients
Diagnoses:
- Risk for hypertension
- Risk for substance abuse
- Impaired sleep pattern
Implementation: Administer doses as prescribed, monitor blood pressure, assess for adverse effects, educate patient about potential for dependence
Evaluation: Evaluate effectiveness in terms of increased attention, decreased impulsivity, and side effect profile
Patient/Family Teaching
- Take medication exactly as prescribed, do not increase dose without consulting provider
- Be aware of potential for dependence and abuse
- Report chest pain, palpitations, or psychiatric symptoms immediately
- Avoid alcohol and other CNS depressants
Special Considerations
Black Box Warnings:
- Potential for abuse and dependence
- Serious cardiovascular events
- Psychiatric adverse effects
Genetic Factors: None specified
Lab Test Interference: None known
Overdose Management
Signs/Symptoms: Severe agitation, hyperthermia, hypertension or hypotension, hallucinations, seizures, cardiac arrhythmias, coma
Treatment: Supportive care, benzodiazepines for agitation, cooling measures for hyperthermia, antihypertensives if needed, gastric lavage if early, activated charcoal, and symptomatic treatment
Storage and Handling
Storage: Store at room temperature, away from light and moisture
Stability: Stable for 2-3 years when stored properly