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Overdose de anfetaminas

Última revisión: 16 Aug 2025
Última actualización: 22 Mar 2022

Resumen

Definición

Anamnesis y examen

Principales factores de diagnóstico

  • 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
Todos los datos

Otros factores de diagnóstico

  • 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
Todos los datos

Factores de riesgo

  • 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
Todos los datos

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

  • 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
Todos los datos

Pruebas diagnósticas que deben considerarse

  • dímero D sérico
  • radiografia abdominal
  • tomografia computadorizada (TC) do crânio
  • ressonância nuclear magnética (RNM) do crânio
  • angiografia cerebral
Todos los datos

治疗流程

急症处理

todos os pacientes

撰稿人

作者

John R. Richards, MD, FAAEM

Professor

Department of Emergency Medicine

University of California, Davis Medical Center

Sacramento

CA

利益声明

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

鸣谢

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

利益声明

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

同行评议者

Andrew Stolbach, MD

Assistant Professor

Department of Emergency Medicine

Johns Hopkins University Hospital

Baltimore

MD

利益声明

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

利益声明

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

利益声明

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.

参考文献

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.

关键文献

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

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

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. 摘要

参考文献

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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