3-31. AMPHETAMINES
The amphetamines are discussed in this subcourse primarily because of their
drug abuse potential.
a. Action and Uses. The amphetamines are sympathomimetic amines with
potent CNS stimulant properties. The amphetamines have a significant potential for
abuse. They should be used with extreme caution and only for limited periods of time
in weight reduction programs. The amphetamines are indicated only in the following
situations:
(1) Attention deficit-hyperactivity disorder (AD-HD), formerly called minimal
brain dysfunction in children.
(2)
Narcolepsy.
(3) In exogenous obesity, as a short-term (a few weeks) adjunct in a
regimen of weight reduction based on caloric restriction.
b. Usual Dosage of Dextroamphetamine Sulfate.
(1)
Narcolepsy: 5-60 mg in divided doses.
(2) Attention deficit-hyperactivity disorder: Not recommended in children
under 3 years of age. For children 3-5 years of age: 2.5 mg daily, increased in
increments of 2.5 mg weekly, until optimum response is obtained. For children 6 years
of age and older: Ten mg once or twice daily, increased in increments of 10 mg weekly
until optimum response is obtained.
(3)
Obesity: 5-30 mg per day in divided doses.
c. Adverse Effects.
(1)
Cardiovascular: Palpitation, tachycardia, elevation of blood pressure.
(2) CNS: Overstimulation, restlessness, dizziness, insomnia, euphoria,
dysphoria, tremor, headache; rarely, psychotic reactions at therapeutic doses.
(3) Other: Dryness of mouth, unpleasant taste, diarrhea, urticaria,
impotence, changes in libido.
d. Overdosage. Restlessness, confusion, assaultiveness00, hallucinations,
and panic states are manifestations of acute poisoning. Fatigue and depression usually
follow the central stimulation. Cardiovascular effects such as arrhythmias, hypertension
or hypotension, and circulatory collapse may be seen. Fatal poisoning usually
terminates in convulsions and coma.
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