Last reviewed: March 2020
Last updated: November
2018
Summary
Definition
History and exam
Key diagnostic factors
- hypervigilance
- hyperarousal
- anxiety
- hallucinations
- chest pain
- paranoia
- increased BP
- dilated pupils
- tachycardia
- hyponatremia
- skin picking, skin lesions, excoriations
- dental decay, gum disease, "meth mouth"
- trismus, bruxism
- dyspnea
- hyperthermia
Other diagnostic factors
- guarded/suspicious behavior
- euphoria
- alertness
- increased concentration
- headache
- irritability
- aggression
- nausea, vomiting
- depression
- anorexia
- increased motor activity
- anhedonia
- hemoptysis
- increased empathy
- pacing
- cardiac arrhythmias
- vasculitis
- cerebral hemorrhage
Risk factors
- history of previous stimulant misuse
- violent or criminal "lifestyle"
- polysubstance misuse
- history of body packing, body stuffing, or "parachuting"
- history of illicit manufacturing or distribution
- preexisting depression
Diagnostic investigations
1st investigations to order
- urine toxicology testing
- gas chromatography/mass spectrometry of urine or blood
- ECG
- serum sodium
- serum creatine phosphokinase
- abdominal x-ray
Treatment algorithm
Contributors
Authors
Professor of Medicine
Anesthesiology, Pharmacology and Toxicology, and Emergency Medicine
Division of Pulmonary and Critical Care Medicine
University of California Davis School of Medicine
Sacramento
CA
Disclosures
TEA declares that he has no competing interests.
Peer reviewers
Associate Clinical Professor of Medicine
University of California San Francisco School of Medicine
San Francisco
CA
Disclosures
RJG declares that he has no competing interests.
Use of this content is subject to our disclaimer