Table 5 Signs of severity of recreational drug poisoning
From: Management of pharmaceutical and recreational drug poisoning
Drug | Clinical severity sign | Paraclinical examinations in search of gravity | |
|---|---|---|---|
Hyperthermia Neurological signs suggestive of stroke Chest pain suggestive of myocardial infarction Seizures | Serum electrolytes; urea/creatinine; CPK; troponin Arterial blood gases Electrocardiogram Signs to look for: Metabolic acidosis Hyponatraemia Rhabdomyolysis Kidney failure Ischaemia/myocardial necrosis Arrythmia and conduction disorder | Expert opinion | |
Benzodiazepines | Respiratory depression | Arterial blood gases | Expert opinion |
Angina | CPK; troponin Electrocardiogram Search for myocardial ischaemia/necrosis | Expert opinion | |
Encephalopathy and extreme agitation leading to endangerment of the patient Seizures Angina | Serum electrolytes; urea-creatinine CPK; troponin Electrocardiogram Look for signs of: Kidney failure Electrolyte disorders Myocardial ischaemia/infarction | Expert opinion | |
Life-threatening encephalopathy and extreme agitation Seizures Cardiorespiratory collapse Respiratory depression Hyperthermia | Serum electrolytes; urea, creatinine CPK; troponin Arterial blood gases Electrocardiogram Look for signs of: Hyponatremia Abnormal serum potassium Kidney failure Rhabdomyolysis Myocardial ischaemia/infarction | Expert opinion | |
Life-threatening encephalopathy and hallucinations | Electrocardiogram (adrenergic signs) | Expert opinion | |
Cardiorespiratory collapse Angina Respiratory failure and aspiration | Electrocardiogram CPK; troponin Look for signs of: Myocardial ischaemia/infarction Arrythmia and conduction disorders (membrane-stabilizing effect) | Expert opinion | |
Respiratory depression Associated toxicity of acetaminophen (when taken concomitantly) | Serum electrolytes; urea, creatinine Transaminases, bilirubin, PT Look for signs of: Hepatocellular insufficiency Kidney failure | Expert opinion | |
Crack [269] | Cardiorespiratory collapse Angina Respiratory failure and aspiration (crack lung) | Electrocardiogram CPK; troponin Look for signs of: Myocardial ischaemia/infarction Arrythmia and conduction disorders (membrane-stabilizing effect) | Expert opinion |
Cardiorespiratory collapse Respiratory depression | Serum electrolytes; urea, creatinine; CPK PT Look for signs of: Kidney failure Rhabdomyolysis Clotting disorders | Expert opinion | |
GHB/GBL [272] | Respiratory depression Seizures | CPK Electrocardiogram (sinus bradycardia, atrioventricular block, U waves) | Expert opinion |
Heroin [273] | Respiratory depression | Serum electrolytes; urea, creatinine; CPK Electrocardiogram Look for signs of: Rhabdomyolysis Kidney failure Myocardial ischaemia/infarction | Expert opinion |
Ketamine/phencyclidine [274] | Respiratory depression | Serum electrolytes; urea, creatinine; CPK Transaminases, bilirubin; PT Look for signs of: Rhabdomyolysis Kidney failure Hyponatraemia Hepatocellular insufficiency | Expert opinion |
Poppers [275] | Cardiorespiratory collapse | Methaemoglobinaemia Arterial blood gases; serum lactate | Expert opinion |
Seizures Respiratory failure Cardiocirculatory collapse Associated toxicity of acetaminophen (when taken concomitantly) | Electrocardiogram (membrane-stabilizing effect) Serum electrolytes; urea, creatinine Transaminases, bilirubin, PT Look for signs of: Hepatocellular insufficiency Kidney failure | Expert opinion |