The clinical pharmacology of intranasal l-methamphetamine

• Published in: BMC clinical pharmacology 2008-07, Vol.8 (4), p.4-4, Article 4
• Main Authors: Mendelson, John E, McGlothlin, Dana, Harris, Debra S, Foster, Elyse, Everhart, Tom, Jacob, 3rd, Peyton, Jones, Reese T
• Format: Article
• Language: English
• Subjects: Administration, Intranasal; Adult; Biological Availability; Blood Pressure - drug effects; Body Temperature - drug effects; Clinical pharmacology; Dosage and administration; Echocardiography; Heart Rate - drug effects; Humans; Methamphetamine; Methamphetamine - administration & dosage; Methamphetamine - blood; Methamphetamine - pharmacokinetics; Methamphetamine - pharmacology; Methamphetamine - urine; Middle Aged; Pain Measurement
• ISSN: 1472-6904; 1472-6904
• DOI: 10.1186/1472-6904-8-4

We studied the pharmacology of l-methamphetamine, the less abused isomer, when used as a nasal decongestant. 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. 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. Inhaled l-methamphetamine delivered from a non-prescription product produced minimal effects but may be a cardiodepressant.