Methamphetamine Hcl

  Action Activates noradrenergic neurons causing CNS and respiratory stimulation; stimulates the satiety center in the brain, causing appetite suppression.

  Indications Treatment of attention deficit disorder in children; short-term exogenous obesity adjunct.

  Contraindications Advanced arteriosclerosis; symptomatic cardiovascular disease; moderate to severe hypertension; hyperthyroidism; hypersensitivity to sympathomimetic amines; glaucoma; agitated states; history of drug abuse. Drug should not be used concomitantly with or within 14 days of MAO inhibitor use.

  Route/Dosage

Attention Deficit Disorder

Children: PO 5 mg 1 to 2 times/day; may be increased weekly by 5 mg to max of 20 to 25 mg/day in divided doses.

Exogenous Obesity

Adults and Children Greater Than 12 yr: PO 5 mg 1 to 3 times/day 30 min before meals. Not to be used beyond a few weeks.

  Interactions

Guanethidine

Amphetamines may decrease effectiveness.

MAO Inhibitors, Furazolidone

Hypertensive crisis and intracranial hemorrhage may occur.

Tricyclic Antidepressants

Decreased amphetamine effect.

Urinary Acidifiers

Decreased amphetamine levels.

Urinary Alkalinizers

Increased amphetamine levels.

  Lab Test Interferences Plasma and urinary steroid levels may be altered.

  Adverse Reactions

CARDIOVASCULAR: Palpitations; tachycardia; hypertension; arrhythmias. CNS: Hyperactivity; dizziness; insomnia; euphoria; restlessness; tremors; headache. DERMATOLOGIC: Urticaria. GI: Dry mouth; unpleasant taste; diarrhea; constipation; anorexia. GU: Impotence.

  Precautions

Pregnancy: Category C. Lactation: Excreted in breast milk. Children: Not recommended as anorectic agent in children less than 12 yr. Drug dependence: Has high potential for dependency and abuse. Tolerance may occur; do not exceed recommended dose. Tartrazine Sensitivity: Some products contain tartrazine, which may cause allergic reactions in susceptible individuals.

  Administration/Storage

• Administer last dose several hours before bedtime.
• Store in tightly closed container at room temperature.

  Assessment/Interventions

• Obtain patient history, including drug history and any known allergies. Note cardiovascular disease, hyperthyroidism, glaucoma, or sensitivity to sympathomimetic drugs.
• Take vital signs and auscultate heart and lungs before administration; monitor closely during treatment.
• Assess the following mental states: mood, sensorium, affect, stimulation, insomnia, aggressiveness. Depressed patients are more likely to misuse drug to induce euphoria and mood elevation.
• Monitor renal function.
• Monitor blood glucose level closely in diabetic patient. Changes in appetite and food intake will occur.
• Monitor for weight loss (may be desired effect).
• If hypertension, dysrhythmias, marked agitation, restlessness, or confusion occur, withhold medication and notify health care provider.

  Patient/Family Education

• Instruct patient to take medication exactly as prescribed and not to increase dosage unless advised by health care provider.
• Advise patient to take sips of water frequently, suck on ice chips or sugarless hard candy, or chew sugarless gum if dry mouth occurs.
• Instruct patient to report excessive dryness of mouth, constipation, or prolonged insomnia as dosage may need to be adjusted.
• Tell patient to avoid caffeine, which increases drug effect.
• Advise patient that drug may cause dizziness and to use caution while driving or performing other tasks requiring mental alertness or coordination.
• Instruct patient not to take otc medications without consulting health care provider.
• Tell parents to report decreased appetite to pediatrician.