Management

1. Supportive care including airway protection, fluid resuscitation, electrolyte correction and, if needed, mechanical ventilation.

2. Early stages of amphetamine poisoning can often be controlled with tepid sponging, chlorpromazine, p-blockade. Forced acid diuresis to increase urinary excretion is rarely needed.

3. Severe complications should be managed as they arise, e.g. rapid cooling for hyperpyrexia, anticonvulsants for seizures, forced alkaline diuresis ± fasciotomies for rhabdomyolysis, platelet and fresh frozen plasma infusions for coagulopathy.

4. Dantrolene may be given to treat the hyperpyrexia at a dose of 1mg/kg IV, repeated to a cumulative maximum dose of 10mg/kg, particularly if the temperature is >40°C.

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