What Not To Do – 2020.06.05

The Clinical Pharmacology of Intranasal l-Methamphetamine


Definition of myocardiumthe middle muscular layer of the heart wall.


PDF-The Clinical Pharmacology of Intranasal l-Methamphetamine


Background

We studied the pharmacology of l-methamphetamine, the less abused isomer, when used as a nasal decongestant.

Methods

12 subjects self-administered l-methamphetamine from a nonprescription inhaler at the recommended dose (16 inhalations over 6 hours) then at 2 and 4 (32 and 64 inhalations) times this dose. In a separate session intravenous phenylephrine (200 μg) and l-methamphetamine (5 mg) were given to define alpha agonist pharmacology and bioavailability. Physiological, cardiovascular, pharmacokinetic, and subjective effects were measured.

Results

Plasma l-methamphetamine levels were often below the level of quantification so bioavailability was estimated by comparing urinary excretion of the intravenous and inhaled doses, yielding delivered dose estimates of 74.0 ± 56.1, 124.7 ± 106.6, and 268.1 ± 220.5 μg for ascending exposures (mean 4.2 ± 3.3 μg/inhalation). Physiological changes were minimal and not dose-dependent. Small decreases in stroke volume and cardiac output suggesting mild cardio-depression were seen.

Conclusion

Inhaled l-methamphetamine delivered from a non-prescription product produced minimal effects but may be a cardio-depressant.