9. CLINICAL EFFECTS
9.1 Acute poisoning
9.1.1 Ingestion
Effects are most marked on the central nervous
system, cardiovascular system, and muscles. The triad
of hyperactivity, hyperpyrexia, and hypertension is
characteristic of acute amphetamine overdosage.
Agitation, confusion, headache, delirium, and
hallucination, can be followed by coma, intracranial
haemorrhage, stroke, and death.
Chest pain, palpitation, hypertension, tachycardia,
atrial and ventricular arrhythmia, and myocardial
infarction can occur.
Muscle contraction, bruxism (jaw-grinding), trismus
(jaw clenching), fasciculation, rhabdomyolysis, are
seen leading to renal failure; and flushing, sweating,
and hyperpyrexia can all occur. Hyperpyrexia can cause
disseminated intravascular coagulation.
(Brust, 1993; Derlet et al., 1989)
9.1.2 Inhalation
The clinical effects are similar to those after
ingestion, but occur more rapidly (Brust, 1993).
9.1.3 Skin exposure
No data available
9.1.4 Eye contact
No data available
9.1.5 Parenteral exposure
Intravenous injection is a common mode of
administration of amphetamine by abusers. The euphoria
produced is more intense, leading to a “rush” or
“flash” which is compared to sexual orgasm (Brust,
1993). Other clinical effects are similar to those
observed after ingestion, but occur more rapidly.
9.1.6 Other
No data available
9.2 Chronic poisoning
9.2.1 Ingestion
Tolerance to the euphoric effects and CNS
stimulation induced by amphetamine develops rapidly,
leading abusers to use larger and larger amounts to
attain and sustain the desired affect.
Habitual use or chronic abuse usually results in toxic
psychosis classically characterised by paranoia,
delusions and hallucinations, which are usually
visual, tactile or olfactory in nature, in contrast to
the typical auditory hallucinations of schizophrenia.
The individual may act on the delusions, resulting in
bizarre violent behaviour, hostility and aggression,
sometimes leading to suicidal or homicidal actions.
Dyskinesia, compulsive behaviour and impaired
performance are common in chronic abusers. The chronic
abuser presents as a restless, garrulous, tremulous
individual who is suspicious and anxious.
