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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  
Amphetamines [253,254,255] 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
Cannabis [256, 257] Angina CPK; troponin
Electrocardiogram
Search for myocardial ischaemia/necrosis
Expert opinion
Synthetic cannabinoids [258, 259] 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
Synthetic cathinones [258, 260, 261] 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
Magic mushrooms [262,263,264] Life-threatening encephalopathy and hallucinations Electrocardiogram (adrenergic signs) Expert opinion
Cocaine [265, 266] 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
Codeine [267, 268] 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
Lysergic acid diethylamide (LSD) [270, 271] 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
Tramadol [276, 277] 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
  1. CPK creatine phosphokinase, GHB γ-hydroxybutyric acid, GBL γ-butyrolactone, PT prothrombin time