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Overdose de anfetaminas

Last reviewed: 4 Aug 2025
Last updated: 22 Mar 2022

Summary

Definition

History and exam

Key diagnostic factors

  • presença de fatores de risco
  • agitação, irracionalidade, inquietação, comportamento agressivo ocasional
  • hipertermia >38 °C (>100 °F) mas <39.5 °C (<103 °F)
  • hipertermia >39.5 °C (>103 °F)
  • convulsões
  • diaforese, rubor facial
  • taquicardia e palpitações
  • lesão traumática
  • cefaleia
  • interação com medicamentos serotoninérgicos
  • hipertensão
  • hiper-reflexia e clônus
  • dor torácica
  • arritmia cardíaca
Full details

Other diagnostic factors

  • história de hepatite B ou C, HIV
  • tremor, movimentos repetitivos
  • desorientação, confusão, delirium
  • desnutrição
  • anormalidades venosas superficiais
  • fala rápida, andar de um lado para outro, trismo
  • alucinações ou delírios
  • tremor, hipertonicidade ou rigidez muscular
  • paranoia, hipervigilância e psicose
  • midríase
  • história de cardiopatia
  • taquipneia
  • dispneia
  • falta de sede
  • dor abdominal
  • reflexo de Babinski positivo
  • sinais neurológicos focais; papiledema
Full details

Risk factors

  • temperatura ambiente elevada
  • depleção de volume
  • exercício físico e sudorese
  • ingestão excessiva de bebidas alcoólicas
  • uso de várias substâncias
  • ansiedade e depressão
  • história de distúrbio comportamental
  • histórico de infrações ou de crimes
  • Transtorno de deficit da atenção com hiperatividade (TDAH)
  • frequentar casas noturnas ou raves
  • história de uso indevido de drogas por >1 ano
  • predileção genética
Full details

Diagnostic investigations

1st investigations to order

  • glicose sérica
  • eletrólitos séricos
  • ureia, creatinina sérica
  • gasometria arterial
  • aspartato aminotransferase, alanina aminotransferase, gama-glutamiltransferase séricas
  • tempo de protrombina sérica, TTP, INR
  • urinálise
  • exame toxicológico da urina
  • nível de álcool sérico
  • creatina quinase sérica
  • troponina sérica
  • eletrocardiograma (ECG)
  • Radiografia torácica
Full details

Investigations to consider

  • dímero D sérico
  • radiografia abdominal
  • tomografia computadorizada (TC) do crânio
  • ressonância nuclear magnética (RNM) do crânio
  • angiografia cerebral
Full details

Treatment algorithm

ACUTE

todos os pacientes

Contributors

Authors

John R. Richards, MD, FAAEM

Professor

Department of Emergency Medicine

University of California, Davis Medical Center

Sacramento

CA

Disclosures

JRR is an author of a number of references cited in this topic.

Acknowledgements

Dr John R. Richards would like to gratefully acknowledge Dr Alison Jones, a previous contributor to this topic.

Disclosures

AJ is an author of a number of references cited in this topic.

Peer reviewers

Andrew Stolbach, MD

Assistant Professor

Department of Emergency Medicine

Johns Hopkins University Hospital

Baltimore

MD

Disclosures

AS declares that he has no competing interests.

Richard J. Geller, MD, MPH, FACP

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.

David Wood, BSc, MB ChB, MD, MRCP

Consultant Physician and Clinical Toxicologist

Guy's and St Thomas' Poisons Unit

London

UK

Disclosures

DW is an author of a reference cited in this topic.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Carvalho M, Carmo H, Costa VM, et al. Toxicity of amphetamines: an update. Arch Toxicol. 2012 Aug;86(8):1167-231. Abstract

Glasner-Edwards S, Mooney LJ. Methamphetamine psychosis: epidemiology and management. CNS Drugs. 2014 Dec;28(12):1115-26.Full text  Abstract

Richards JR, Albertson TE, Derlet RW, et al. Treatment of toxicity from amphetamines, related derivatives, and analogues: a systematic clinical review. Drug Alcohol Depend. 2015 May 1;150:1-13. Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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