Treatment of toxicity from amphetamines, related derivatives, and analogues: A systematic clinical review

摘要: Abstract Background Overdose of amphetamine, related derivatives, and analogues (ARDA) continues to be a serious worldwide health problem. Patients frequently present the hospital require treatment for agitation, psychosis, hyperadrenegic symptoms leading pathologic sequelae mortality. Objective To review pharmacologic hyperadrenergic state resulting from ARDA toxicity. Methods MEDLINE, PsycINFO, Cochrane Library were searched inception September 2014. Articles on ARDA-induced selected. Evidence was graded using Oxford CEBM. Treatment recommendations compared current ACCF/AHA guidelines. Results The search resulted in 6082 articles with 81 eligible involving 835 human subjects. There 6 high-quality studies supporting use antipsychotics benzodiazepines control agitation psychosis. several case reports detailing successful dexmedetomidine this indication. 9 reporting overall safety efficacy β-blockers hypertension tachycardia associated ARDA. 3 calcium channel blockers. 2 level I α-blockers small number nitric oxide-mediated vasodilators. Conclusions High-quality evidence overdose is limited but can help guide management acute tachycardia, hypertension. butyrophenone later-generation antipsychotics, benzodiazepines, recommended based existing evidence. Future randomized prospective trials are needed evaluate new agents further define these patients.