d-methamphetamine

CAS RN: 537-46-2

Health Effects

0.2.1 SUMMARY OF EXPOSURE
  • 0.2.1.1 ACUTE EXPOSURE
    • A) USES: Amphetamines and related agents are CNS stimulants. They are sold as commercial pharmaceutical agents to treat medical conditions (eg, attention deficit disorder, narcolepsy, and obesity). Illicit amphetamines, such as hallucinogenic amphetamines, methamphetamine, and methylphenidate, are covered in separate managements.
    • B) PHARMACOLOGY: Amphetamines are sympathomimetic agents structurally related to norepinephrine. They have greater stimulant effects than other catecholamines. Peripherally, amphetamines promote the release of norepinephrine from stores in adrenergic nerve terminals and directly stimulate alpha- and beta-adrenergic receptors. They also inhibit catecholamine metabolism by inhibiting monoamine oxidase enzymes. Centrally, amphetamines stimulate the cerebral cortex, medullary respiratory center, and reticular activating system.
    • C) TOXICOLOGY: Overdose or chronic excessive use causes a sympathomimetic toxidrome (eg, tachycardia, hypertension, agitation, and, in severe cases, psychosis).
    • D) EPIDEMIOLOGY: Exposures are common. Severe effects are rare but may be seen in large overdoses and chronic exposures. Diversion and abuse of pharmaceutical amphetamines is common.
    • E) WITH THERAPEUTIC USE
      • 1) Tachycardia, hypertension, agitation, dyskinesias, psychosis, and seizures. Dose response may be unpredictable. Chronic amphetamine abuse may result in cardiomyopathy, heart failure, malnutrition, weight loss, cerebral vasculitis, permanent psychiatric illness including depression and paranoid psychoses, bruxism, and infection. Amphetamine exposure to the fetus may cause neonatal withdrawal symptoms. An adult withdrawal syndrome has been described in chronic abusers, including severe depression.
    • F) WITH POISONING/EXPOSURE
      • 1) MILD TO MODERATE POISONING: Hyperactivity, diaphoresis, flushing, mydriasis, nausea, vomiting, abdominal pain, hypertension, palpitations, tachycardia, chest pain, headache, hyperventilation, and confusion.
      • 2) SEVERE POISONING: Generally only seen after illicit use (usually by injection, insufflations, or smoking) of high doses. May cause hyperthermia (greater than 40 degrees C can be life-threatening), dehydration, severe hypertension, tachydysrhythmia, myocardial infarction, vasospasm, aortic dissection, cerebral vascular accidents, sudden cardiac death, pneumothorax, psychosis, seizures, ischemic colitis, rhabdomyolysis, renal failure, hepatic failure, serotonin syndrome, delirium, paranoia, and coma. Rarely, severe acidosis, multiorgan failure, and death occur.
0.2.3 VITAL SIGNS0.2.20 REPRODUCTIVE HAZARDS
  • A) Benzphetamine, phendimetrazine, and phentermine (as monotherapy or in combination with topiramate) are classified as FDA pregnancy category X. Amphetamines/dextroamphetamines, amphetamine sulfate, dextroamphetamine, methamphetamines, and lisdexamfetamine are classified as FDA pregnancy category C. Diethylpropion is classified by the manufacturer as FDA pregnancy category B. Amphetamine use during pregnancy has been associated with congenital anomalies (ie, biliary atresia and cleft palate), aggressive behavior, withdrawal symptoms, low birth weights, premature births, fetal distress, and, in some cases, death. Methamphetamines have been shown to cross the placenta.
  • B) Amphetamines have been measured in breast milk in several case reports.
0.2.21 CARCINOGENICITY
  • 0.2.21.1 IARC CATEGORY
    • A) IARC Carcinogenicity Ratings for CAS300-62-9 (International Agency for Research on Cancer (IARC), 2016; International Agency for Research on Cancer, 2015; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010a; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2008; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2007; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2006; IARC, 2004):
      • 1) Not Listed
    • B) IARC Carcinogenicity Ratings for CAS139-10-6 (International Agency for Research on Cancer (IARC), 2016; International Agency for Research on Cancer, 2015; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010a; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2008; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2007; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2006; IARC, 2004):
      • 1) Not Listed
    • C) IARC Carcinogenicity Ratings for CAS156-08-1 (International Agency for Research on Cancer (IARC), 2016; International Agency for Research on Cancer, 2015; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010a; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2008; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2007; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2006; IARC, 2004):
      • 1) Not Listed
    • D) IARC Carcinogenicity Ratings for CAS5411-22-3 (International Agency for Research on Cancer (IARC), 2016; International Agency for Research on Cancer, 2015; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010a; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2008; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2007; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2006; IARC, 2004):
      • 1) Not Listed
    • E) IARC Carcinogenicity Ratings for CAS51-63-8 (International Agency for Research on Cancer (IARC), 2016; International Agency for Research on Cancer, 2015; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010a; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2008; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2007; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2006; IARC, 2004):
      • 1) Not Listed
    • F) IARC Carcinogenicity Ratings for CAS90-84-6 (International Agency for Research on Cancer (IARC), 2016; International Agency for Research on Cancer, 2015; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010a; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2008; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2007; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2006; IARC, 2004):
      • 1) Not Listed
    • G) IARC Carcinogenicity Ratings for CAS22232-71-9 (International Agency for Research on Cancer (IARC), 2016; International Agency for Research on Cancer, 2015; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010a; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2008; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2007; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2006; IARC, 2004):
      • 1) Not Listed
    • H) IARC Carcinogenicity Ratings for CAS2152-34-3 (International Agency for Research on Cancer (IARC), 2016; International Agency for Research on Cancer, 2015; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010a; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2008; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2007; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2006; IARC, 2004):
      • 1) Not Listed
    • I) IARC Carcinogenicity Ratings for CAS122-09-8 (International Agency for Research on Cancer (IARC), 2016; International Agency for Research on Cancer, 2015; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010a; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2008; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2007; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2006; IARC, 2004):
      • 1) Not Listed
  • 0.2.21.2 HUMAN OVERVIEW
    • A) AMPHETAMINE SULFATE
      • 1) At the time of this review, the manufacturer does not report any carcinogenic potential of amphetamine sulfate in humans (Prod Info EVEKEO(TM) oral tablets, 2015).
  • 0.2.21.3 ANIMAL OVERVIEW
    • A) AMPHETAMINE SULFATE
      • 1) At the time of this review, the manufacturer does not report any carcinogenic potential of amphetamine sulfate in animals (Prod Info EVEKEO(TM) oral tablets, 2015).
0.2.22 GENOTOXICITY
  • A) AMPHETAMINE
    • 1) There was no evidence of mutagenicity in the in vivo mouse bone marrow micronucleus test or the E. coli component of the in vitro Ames test. The d, l-amphetamine enantiomer produced a positive response in the mouse bone marrow micronucleus test and Ames test and a negative response in the in vitro sister chromatid exchange and chromosomal aberration assay (Prod Info DYANAVEL(TM) XR extended-release oral suspension, 2015).
Find more information on this substance at: PubChem, PubMed