Metamfetamine

Abstract

Worsening of pulmonary arterial hypertension: 2 case reports A report described a 48-year-old woman and 39-year-old woman experienced worsening of pulmonary arterial hypertension (PAH) following metamfetamine additcion. Of which, one woman had been abusing metamfetamine [routes, dosages, duration of treatments to reactions onsets not stated and outcomes not stated]. Case 1: The 48-year-old woman, who had metamfetamine [methamphetamine]-associated PAH, had been receiving unspecified triple combination therapy. She had been stable on her current unspecified regimen; however, she acutely developed worsening symptoms. Then, she underwent right heart catheterisation. Her haemodynamics showed the following: right atrial pressure 15mm Hg, pulmonary artery pressure 64/27mm Hg, mean pulmonary artery pressure 44mm Hg, cardiac index 1.76 L/min/m2 and pulmonary vascular resistance 8.6 Wood units. After initially denying; later, she admitted to relapse of metamfetamine use. Urine drug screen prior to the right heart catheterisation confirmed positive exposure to metamfetamine. Thus, metamfetamine was withdrawn. After cessation of metamfetamine urine drug screen was noted to be negative. A repeat haemodynamics showed right atrial pressure 11mm Hg, pulmonary artery pressure 58/29mm Hg, mean pulmonary artery pressure 41mm Hg, cardiac index 3.12 L/min/m2, pulmonary vascular resistance 5.9 Wood units. Later, it was confirmed that the worsening of PAH was associated with metamfetamine addiction. Case 2: A 39-year-old woman with prior metamfetamine use and metamfetamine-associated pulmonary arterial hypertension, presented for evaluation of dyspnoea. Her urine drug screen was negative and haemodynamics confirmed severe PAH. Prior to initiation of unspecified combination PAH therapy, she was found to have a positive urine drug screen for metamfetamine. Then, she was advised to abstain from metamfetamine. At a follow up, urine drug screen remained positive and right heart catheterisation revealed worsening hemodynamics with right atrial pressure 16mm Hg, pulmonary artery pressure 81/40mm Hg, mean pulmonary artery pressure 54mm Hg, cardiac index 1.19 L/min/m2, pulmonary vascular resistance 20.6 Wood units. Due to active metamfetamine abuse, she was treated with unspecified combination PAH therapy. Later, it was confirmed that the worsening of PAH was associated with metamfetamine addiction.