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The clinical pharmacology of intranasal l-methamphetamine.

  • Author(s): Mendelson, John E
  • McGlothlin, Dana
  • Harris, Debra S
  • Foster, Elyse
  • Everhart, Tom
  • Jacob, Peyton
  • Jones, Reese T
  • et al.
Abstract

Background

We studied the pharmacology of l-methamphetamine, the less abused isomer, when used as a nasal decongestant.

Methods

12 subjects self-administered l-methamphetamine from a nonprescription inhaler at the recommended dose (16 inhalations over 6 hours) then at 2 and 4 (32 and 64 inhalations) times this dose. In a separate session intravenous phenylephrine (200 microg) and l-methamphetamine (5 mg) were given to define alpha agonist pharmacology and bioavailability. Physiological, cardiovascular, pharmacokinetic, and subjective effects were measured.

Results

Plasma l-methamphetamine levels were often below the level of quantification so bioavailability was estimated by comparing urinary excretion of the intravenous and inhaled doses, yielding delivered dose estimates of 74.0 +/- 56.1, 124.7 +/- 106.6, and 268.1 +/- 220.5 microg for ascending exposures (mean 4.2 +/- 3.3 microg/inhalation). Physiological changes were minimal and not dose-dependent. Small decreases in stroke volume and cardiac output suggesting mild cardiodepression were seen.

Conclusion

Inhaled l-methamphetamine delivered from a non-prescription product produced minimal effects but may be a cardiodepressant.

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