Hypertension in acute amphetamine intoxication

Q: The drug of choice to treat hypertension in acute amphetamine intoxication is? (select one)

A) benzodiazepine

B) Esmolol

C) Lopressor

D) Propranolol

Answer: A

Like cocaine intoxication, beta-blockers (BB) should be avoided in acute amphetamine intoxication (choices B, C, and D). The first line of treatment is benzodiazepines. If further help is needed, non-BB should be used, such as nitroglycerin or nitroprusside. 

If no choice is left and BB is absolutely needed, it would be prudent to add an alpha antagonist.

#hemodynamic

#toxicology

#pharmacology

Reference: 

1. White SR. Amphetamine toxicity. Semin Respir Crit Care Med. 2002 Feb;23(1):27-36. doi: 10.1055/s-2002-20586. PMID: 16088595.

2. Ferdinand KC. Substance Abuse and Hypertension. J Clin Hypertens (Greenwich). 2000 Jan;2(1):37-40. PMID: 11416624.