case studies

Question 1

26-year-old methamphetamine user brought by friends due to extreme agitation after sleeping only 48 hrs & poor intake for days. Vitals: HR 100, BP 160/100, Temp 39°C, RR 30. Exam: IV marks on arms, hand tremor. Treated with sedative, diuretic, and parenteral ammonium chloride. Why ammonium chloride?

Answer 1

To acidify urine → ionize methamphetamine (weak base) → trap in urine → increase renal excretion