Mendelson J, Jones R T, Upton R, Jacob P
Drug Dependence Research Center, Langley Porter Psychiatric Institute, University of California, San Francisco 94143-0984, USA.
Clin Pharmacol Ther. 1995 May;57(5):559-68. doi: 10.1016/0009-9236(95)90041-1.
Methamphetamine and ethanol are commonly used together. We examined the effects of intravenous methamphetamine (30 mg), oral ethanol (1 gm/kg), and the combination of methamphetamine (30 mg) and ethanol (1 gm/kg).
Eight methamphetamine and ethanol users were studied in a double-blind, double-placebo, within-subject, balanced Latin-square design. Ethanol was administered in six drinks over 30 minutes. Methamphetamine was injected 60 minutes after the first drink was begun. Cardiovascular, subjective, and neuropsychologic effects of the drug combinations were measured for 6 hours. Methamphetamine and amphetamine in plasma and urine were measured by capillary gas chromatography for 48 hours. Data were analyzed by repeated-measures ANOVA.
Compared with methamphetamine alone, the combination increased heart rate but decreased systolic blood pressure. The net cardiovascular effect was an increase in rate pressure product, an index of cardiac work and myocardial oxygen consumption. The combination diminished the subjective effects of ethanol while not affecting the subjective effects of methamphetamine. Methamphetamine pharmacokinetics were not altered by the concurrent administration of ethanol, with the exception of lowering the apparent volume of distribution at steady state for methamphetamine.
As a potent sympathomimetic drug with alpha-agonist-like effects, methamphetamine increased systolic blood pressure, with minimal change in heart rate. The concurrent administration of methamphetamine and ethanol increased cardiac work, which could produce more adverse cardiovascular effects than either drug taken alone. The increased perceived global intoxication may explain the popularity of this drug combination.
甲基苯丙胺和乙醇常一起使用。我们研究了静脉注射甲基苯丙胺（30毫克）、口服乙醇（1克/千克）以及甲基苯丙胺（30毫克）与乙醇（1克/千克）联合使用的效果。
对8名甲基苯丙胺和乙醇使用者进行了双盲、双安慰剂、受试者内平衡拉丁方设计研究。乙醇在30分钟内分六次饮用。在开始饮用第一杯乙醇60分钟后注射甲基苯丙胺。对药物组合的心血管、主观和神经心理效应进行6小时测量。通过毛细管气相色谱法在48小时内测量血浆和尿液中的甲基苯丙胺和苯丙胺。数据采用重复测量方差分析进行分析。
与单独使用甲基苯丙胺相比，联合使用可使心率增加，但收缩压降低。净心血管效应是心率血压乘积增加，这是心脏做功和心肌氧消耗的一个指标。联合使用减弱了乙醇的主观效应，同时不影响甲基苯丙胺的主观效应。除了降低甲基苯丙胺稳态时的表观分布容积外，乙醇的同时给药并未改变甲基苯丙胺的药代动力学。
作为一种具有α-激动剂样作用的强效拟交感神经药物，甲基苯丙胺可增加收缩压，心率变化最小。甲基苯丙胺和乙醇同时给药增加了心脏做功，这可能比单独使用任何一种药物产生更多不良心血管效应。感知到的整体中毒增加可能解释了这种药物组合的流行。
