determine
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A 22-year-old male with a history of substance abuse, is brought to the emergency room by police. He demonstrates violent behavior, slurred speech and muscular rigidity. Which one of the following drugs is most likely to be associated with the clinical presentation?<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />
1) cocaine
2) phencyclidine
3) amphetamines
4) steroids
5) alcohol
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| yasmeen
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PHENCYCLIDINE
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| achilles
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2-phencycliidne
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| mesh
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2 phencyclidine
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| babli
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Physical: Based on a study by McCarron et al in which 1,000 patients presenting with acute phencyclidine intoxication were evaluated, clinical effects ranged from lethargy and coma to extreme agitation and psychosis.
Common physical examination findings include the following:
* Nystagmus (horizontal, vertical, or rotary) - Often considered a hallmark of PCP intoxication (57-89%)
* Hypertension (57%)
* Acute brain syndrome involving confusion, amnesia, disorientation, and violence (37%)
* Agitation and violent behavior (35%)
* Tachycardia (30%)
* Bizarre behavior including public nudity (29%)
* Hallucinations and delusions (19%)
* Miosis - Often reported with a blank stare
* Rare findings - Usually only seen with high doses
o Seizures (3.1%)
o Dystonia
o Ataxia
o Apnea (often seen with co-ingestants)
o Catatonia
o Coma - PCP coma usually presents with nystagmus and the absence of respiratory depression. Unlike opioid-induced coma, it does not improve with naloxone.
o Hypertensive crisis
o Intracranial and subarachnoid hemorrhage
* Other manifestations include the following:
o Hyperthermia, hyperreflexia, and muscle rigidity have been reported.
o Rhabdomyolysis with or without acute renal failure may also occur.
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| Rasul
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Thx, babli, comprehensive list!
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| AAAAA
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Thanks PCP
Horizontal nystagmus----> Dilantin toxicity
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| frank100
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