AGENTS
- withdrawal states
- amphetamines
- cocaine
- theophylline
- BZP
- hypermetabolic syndromes (MH, NMS)
- MAO-I
- other novel recreational drugs (e.g. Meow-Meow)
CLINICAL FEATURES
- delusions
- paranoia
- tachycardia
- hypertension
- hypotension (severe)
- hyperthermia
- sweating
- piloerection
- mydriasis
- hyperreflexia
- seizures
SPECIFIC MANAGEMENT AND TRIGGERS FOR INTERVENTION
- activate charcoal: only post-intubation if risk of seizures or coma
- whole bowel irrigation: consider in body packers
- benzodiazepinea: agitation/delirium
- titrated anti-adrenergics (avoid beta-blockers due to unapposed alpha agonism, except for theophylline)
- monitoring for end-organ ischaemia: MI, CVA
- CVVHDF:
-> not recommended in amphetamines, cocaine, BZP, MAO-I
-> recommended in theophylline - laparotomy: body packers with ruptured pack
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