Drug
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Also known as
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Assessment
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Investigations
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Management
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Notes
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AmphetaminesÌý
(small dose may produce significant toxicity)
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Ice, speed, gooey, whiz, base, ecstasy, love drug, MDMA, MD
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Central & peripheral sympathomimetic effects:
Ìý-Ìý agitation, sweating, tachycardia, hypertension
Medical complications:
- severe hyperthermia, rhabdomyolysis, seizures, intracranial haemorrhage, hyponatraemia, cerebral oedema
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- 12 lead ECG
- BSL
- Electrolytes & renal function, CK, troponinÌý
- Consider intracranial imaging if any concern regarding vascular dissection
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Safe, low stimulus environmentÌý
Continuous cardiac monitoringÌý
Benzodiazepines to control agitation
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Ìý |
CannabisÌý
(dose related effects)
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Marijuana, grass, pot, weed, ganja, dope, hashish
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Mild sedation, euphoria, disinhibition progressing to CNS depression, anxiety & psychotic symptoms, postural hypotension & tachycardia
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N/A
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Benign symptoms:Ìý
- supportive care until asymptomaticÌý
Anxiety:
- DiazepamÌý
Cardiovascular effects: - IV fluids
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Ìý |
Gamma-Hydroxybutyrate (GHB)
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G, fantasy, easy lay, grievous bodily harm, cherry meth, liquid E
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CNS & respiratory depression progressing to coma
Ìý
Bradycardia & myoclonic jerks
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N/A
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Resuscitation environment
Ìý
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Expect improvement within 4-6 hours
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Hallucinogens
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Datura sp., Angels trumpet, magic mushrooms, LSD
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Central & peripheral anti-cholinergic toxidrome
- agitation, delirium, hallucinations, mydriasis, tachycardia, dry flushed skin
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N/A
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Supportive careÌý
Treat delirium with titrated diazepam
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Anti-psychotic major tranquilisers (eg haloperidol) may worsen anti-cholinergic symptoms
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Inhalants/Volatile Substance Abuse
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Huffing, bagging, sniffing, chroming
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Similar effects to alcohol intoxication:
- initial euphoria & disinhibition followed by CNS depressionÌý
Acute medical complications:
- sustained 'high', encephalopathy & seizures, methaemoglobinaemia, cardiac arrhythmia & sudden death
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Ìý |
Treat behavioural disturbance/delirium with diazepam
Ìý
Cardiac arrest resuscitation should limit the use of exogenous adrenaline
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Ìý |
Opiates
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Ìý
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CNS & respiratory depression associated with miosisÌý
Dextropropoxyphene (Digesic)Ìý- seizures & arrhythmiasÌý
TramadolÌý- seizures & serotonin syndrome
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Ìý
|
Monitor for CNS & respiratory depressionÌý
Airway protection & ventilation ensures good outcomeÌý
Naloxone infusion
(note short half life)Ìý
Treat seizures with benzodiazepines and phenobarbitone
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Ìý |