Legally High

A 24-year-old is brought to the emergency department by EMS after being found altered outside a fast food restaurant talking to inanimate objects. Initial vital signs on arrival include a blood pressure of 145/92 mm Hg, heart rate of 126 bpm, respiratory rate of 22 bpm, temperature of 98.4°F, and pulse oximetry of 100% on room air.   The patient is awake, alert, but oriented x 0. He is tachycardic, dry, flushed, and his mydriatic pupils measure 5 mm in diameter. The patient repeatedly was asking to go to the bathroom, and after multiple attempts, ultrasound was used to scan his bladder. It was determined that he had 500 ml of urine in his bladder.   What are five legal highs that are commonly abused? 1. Dextromethorphan is commonly found in formulations of cough medications, including Robitussin. It shares a common structure with other opiates yet has no analgesic properties, and it may cause CNS depression and miosis at high doses. Patients generally experience a dysphoria similar to PCP. 2. Doxylamine is available as a sleep aid (including Unisom) and in combination products used to treat allergic rhinitis. It is a first-generation H1-antihistamine, and produces anticholinergic effects at high doses. 3. Inhalants are a diverse group of volatile agents that includes gasoline, paint, hair spray, glues, paint thinners, and air fresheners. Acute effects include euphoria, stimulation, and disinhibition. Chronic abuse may result in neurological and neuropsychological ef...
Source: The Tox Cave - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs