Table 5.
Signs of severity of recreational drug poisoning
| Drug | Clinical severity sign | Paraclinical examinations in search of gravity | |
|---|---|---|---|
| Amphetamines [253–255] |
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 [262–264] | 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 |
CPK creatine phosphokinase, GHB γ-hydroxybutyric acid, GBL γ-butyrolactone, PT prothrombin time