Hypertension dextroamphetamine

The acute effects of psychomotor stimulant overdoses are related to their CNS stimulant properties and may include euphoria, dizziness, tremor, irritability, and insomnia. At higher doses, convulsions and coma may ensue. These drugs are cardiac stimulants and may cause headache, palpitation, cardiac arrhythmias, anginal pain, and either hypotension or hypertension. Dextroamphetamine produces somewhat less cardiac stimulation. Chronic intoxication, in addition to these symptoms, commonly results in weight loss and a psychotic reaction that is often diagnosed as schizophrenia. 

The risk of tachycardia, hypertension, and cardiotoxicity is increased with coadministration of dronabinol (an antiemetic) and dextroamphetamine. In addition, administration of dextroamphetamine with MAOIs may increase the risk of hypertensive crisis. Al-kalinizing agents can speed absorption (e.g., antacids) or delay urinary excretion (e.g., acetazolamide, thiazide diuretics) of dextroamphetamine, thus potentiating its effects. Gastric or urinary acidifying agents (e.g., ascorbic acid, ammonium chloride) can decrease the effects of dextroamphetamine. Propoxyphene overdose can potentiate amphetamine central nervous system stimulation, potentially resulting in fatal convulsions. 

Dextroamphetamine can make tics worse, so its use may not be recommended for someone with Tourette s syndome or another tic disorder. Anyone who suffers from hypertension, arteriosclerosis, hyperthyroidism, or glaucoma should also not take dextroamphetamines. 

Monoamine oxidase inhibitors and many pharmacological agents are synergistic, sometimes resulting in a hypertensive crisis. The agents with which the MAOIs may be synergistic include amphetamine, dextroamphetamine, methyl amphetamine, ephedrine, procaine preparations (which usually contain norepinephrine), epinephrine, methyldopa, and phenylpropanolamine (over-the-counter cold preparations). 

Dextroamphetamine is a sympathomimetic amine that is used in narcolepsy and in attention-deficit disorder (ADD) in children. Dextroamphetamine releases norepinephrine and, in high doses, also dopamine. It is absorbed from the GI tract, metabolized in the liver, and excreted unchanged in the urine. Acidification of urine shortens amphetamine s half-life, whereas alkalinization of urine prolongs it. The accumulation of hydroxy metabofite of amphetamine has been thought to cause amphetamine-induced psychosis. Therapeutic doses of amphetamine may cause insomnia, tremor, and restlessness, and toxic doses of amphetamine may cause mydriasis, hypertension, and arrhythmia. Chlor-promazine is an excellent antidote in amphetamine toxicity. 

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