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Heroin
6%
6/94
Ketamine
3%
3/94
Phencyclidine
18%
17/94
3,4-methylenedioxymethamphetamine
55%
52/94
Lysergic acid diethylamide
14%
13/94
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This patient most likely consumed 3,4-methylenedioxymethamphetamine (MDMA). MDMA, also known as "Molly" or "ecstasy" is a recreational drug with sympathomimetic properties accomplished by its increase release of endogenous catecholamine and inhibition of catecholamine re-uptake. It also increases serotonin levels. Patients can present with hyperthermia, hypertension, and tachycardia; as well as, increased alertness and feelings of increased physical and mental powers. Patients may be hyponatremic due to their increased water intake and, in some patients, persistent anti-diuretic hormone release. Incorrect Answers: Answer 1: Heroin intoxication includes nausea and vomiting with constipation, respiratory depression, pupillary constriction, and seizures. A clue to heroin use is to look for track marks. Answer 2: Ketamine intoxication presents with disorientation, hallucinations, severe dissociation from body/self, and at high doses can cause stupor or coma. Answer 3: PCP intoxication presents with belligerence, impulsiveness, homicidality, psychosis, psychomotor agitation, vertical and horizontal nystagmus, tachycardia, and ataxia. Answer 5: LSD intoxication presents with visual hallucinations, synesthesias, delusions, and pupillary dilation.
4.3
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