Central Nervous System Stimulants

#CEN tip of the day

Central Nervous System Stimulants (Cocaine, methamphetamine)

• S/S: Agitation, aggressiveness, mydriasis, hypertension, tachycardia, hyperthermia, dysrhythmias, and paranoia.

• TX: Fluid resuscitation, activated charcoal, benzodiazepines, cool patient aggressively, vasodilators.

• Complications: Hemorrhagic stroke, coronary artery vasospasm (Prinzmetal’s Angina), MI, rhabdomyolysis leading to hyperkalemia and acute tubular necrosis (ATN).

Whole bowel irrigation or surgical removal for ingested cocaine balloons “body packers”.

Designer Drugs “Bath Salts” and “Synthetic Cannabinoids”

• S/S: Hallucinations, paranoia, excited delirium, tachycardia, hypertension.

Hallucinogen - Lysergic Acid Diethylamide (LSD)

• S/S: Distorted reality, tachycardia, hypertension, dilated pupils, hyperthermia, “flashbacks” in long-term use.

Hallucinogen – Phencyclidine (PCP)

• S/S: Delusions, hallucinations, paranoia, dilated pupils, lack of pain sensation so increased strength.