PMID- 30215997
OWN - NLM
STAT- MEDLINE
DCOM- 20190801
LR  - 20190801
IS  - 1532-0650 (Electronic)
IS  - 0002-838X (Linking)
VI  - 98
IP  - 2
DP  - 2018 Jul 15
TI  - Stimulant and Designer Drug Use: Primary Care Management.
PG  - 85-92
AB  - Approximately 10% of the U.S. population 12 years and older reported using 
      illicit substances in 2015. This article reviews the clinical effects and 
      treatment of persons who use cocaine, methamphetamines, 
      3,4-methylenedioxymethamphetamine (MDMA), synthetic cannabinoids, and synthetic 
      cathinones ("bath salts"). Cocaine blocks the reuptake of the monoamine 
      transporters dopamine, norepinephrine, and serotonin. Immediate clinical effects 
      include increased energy and euphoria, as well as hypertension and arrhythmias. 
      Acute myocardial infarction, seizures, hallucinations, hyperthermia, and movement 
      disorders are among the possible adverse effects. Like cocaine, methamphetamine 
      blocks reuptake of monoamine transporters, but also stimulates dopamine release 
      and has a longer duration of action. Methamphetamine misuse is associated with 
      severe dental problems. MDMA is a stimulant and psychedelic with a chemical 
      structure similar to serotonin. Adverse effects include serotonin syndrome, 
      hyponatremia, long-term memory impairment, and mood disorders. Synthetic 
      cannabinoids can have a more intense and long-lasting effect than natural 
      cannabis. Acute intoxication may cause severe cardiac and respiratory 
      complications and seizures. Synthetic cathinones are marketed as cheap 
      substitutes for other stimulants. Their effects are similar to those of other 
      stimulants, and they are addictive. Psychosocial intervention is the main form of 
      treatment for addiction to these substances. Promising therapies include 
      disulfiram and substitution therapy for cocaine misuse disorders, and mirtazapine 
      for methamphetamine use disorder.
FAU - Klega, Ann E
AU  - Klega AE
AD  - Florida Hospital Family Medicine Residency, Winter Park, FL, USA.
FAU - Keehbauch, Jennifer Tickal
AU  - Keehbauch JT
AD  - Loma Linda University School of Medicine, Loma Linda, CA, USA.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Am Fam Physician
JT  - American family physician
JID - 1272646
RN  - 0 (Alkaloids)
RN  - 0 (Cannabinoids)
RN  - 0 (Central Nervous System Stimulants)
RN  - 0 (Crack Cocaine)
RN  - 0 (Designer Drugs)
RN  - 0 (Psychotropic Drugs)
RN  - 44RAL3456C (Methamphetamine)
RN  - 540EI4406J (cathinone)
RN  - KE1SEN21RM (N-Methyl-3,4-methylenedioxyamphetamine)
MH  - Alkaloids/adverse effects/pharmacology
MH  - Amphetamine-Related Disorders/diagnosis/therapy
MH  - Cannabinoids/adverse effects/pharmacology
MH  - Central Nervous System Stimulants/adverse effects
MH  - Cocaine-Related Disorders/diagnosis/therapy
MH  - Counseling/methods
MH  - Crack Cocaine/adverse effects/pharmacology
MH  - Designer Drugs/*adverse effects/pharmacology
MH  - Humans
MH  - Methamphetamine/adverse effects/pharmacology
MH  - N-Methyl-3,4-methylenedioxyamphetamine/adverse effects/pharmacology
MH  - Primary Health Care/*methods
MH  - Psychotropic Drugs/adverse effects/pharmacology
EDAT- 2018/09/15 06:00
MHDA- 2019/08/02 06:00
CRDT- 2018/09/15 06:00
PHST- 2018/09/15 06:00 [entrez]
PHST- 2018/09/15 06:00 [pubmed]
PHST- 2019/08/02 06:00 [medline]
AID - d13700 [pii]
PST - ppublish
SO  - Am Fam Physician. 2018 Jul 15;98(2):85-92.