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Cardiovascular effects of intranasal L‐methamphetamine
Author(s) -
Nath R. P.,
McGlothlin D.,
Uemura N.,
Fernandez E.,
Jones R. T.,
Mendelson J. E.
Publication year - 2004
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1016/j.clpt.2003.11.269
Subject(s) - medicine , pharmacodynamics , nasal decongestant , clinical pharmacology , pharmacology , anesthesia , phenylephrine , inhaler , pseudoephedrine , asthma , pharmacokinetics , ephedrine , blood pressure
Despite the possible risk of stroke, over‐the‐counter (OTC) nasal decongestants are widely used but there are little published data on pharmacodynamic effects. We studied the cardiovascular (CV) pharmacodynamics of the Vicks™ Vapor Inhaler™, an OTC decongestant that has 1‐methamphetamine (1‐MA; nominally a DEA schedule II drug) as its active ingredient. Twelve normotensive nondrug using subjects were enrolled in an ascending dose, open‐label, 3 treatment, 3 period study and dosed with the Vicks inhaler at the manufacturer's maximum recommended dose, and 2 and 4 times that dose over 8 hours. In a separate session, a 200 μg iv dose of phenylephrine was given as a comparator for alpha‐adrenergic response. Cardiovascular effects were non‐invasively assessed with impedance and 2D stress echocardiography; data were analyzed by ANOVA. Results show that inhaled 1‐MA had no acute effects on CV measures; measures were sensitive enough to detect circadian variation and the effects of exercise on multiple CV parameters, but there were no effects of 1‐MA. Plasma 1‐MA levels were always below detection limits; urine 1‐MA concentration increased in a dose proportional manner. Visual analog measures of 'any drug', 'good drug', and 'dizziness' significantly increased from baseline (p<.05) in the 2 higher dose sessions. We conclude that inhaled 1‐MA produces no acute alterations in cardiovascular function even at doses of 4 times the recommended amount. Clinical Pharmacology & Therapeutics (2004) 75 , P71–P71; doi: 10.1016/j.clpt.2003.11.269