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INFORMATION
NEEDED
Airway
Breathing
Circulation
Decontamination
Enhanced elimination
Focused therapy (antidote)
Get help (toxicology consultation)
GENERAL
MANAGEMENT
Adapated from: http://www.kfx.org.uk/drug_facts/drug_facts_images_and_pdfs/rcb9.jpg
Synth Cath
Codeine /
Promethazine
N-Bomb
Synth MJ
GHB
Codeine/Promethazine Syrup
• Euphoriant
– Consumed in a mixture of soda and candy
– Popularized by hip-hop culture
• Street names: Syrup, Purple Drank,
Sizzurp, Lean
• In KY, must be > 18 to purchase
• Seizures, cardiac arrest, respiratory arrest
• Acute Treatment Considerations
– Support vitals; anticipate seizures
http://www.drugabuse.gov/drugs-abuse/emerging-trends
http://www.drugfree.org/newsroom/rapper-lil-wayne-released-from-hospital-after-seizures-linked-to-reported-use-of-sizzurp
GHB
• Gamma hydroxybutyrate
– Dose-related CNS depressant
• CIII prescription drug for cataplexy-
associated narcolepsy (sodium oxybate;
Xyrem®)
– CI without prescription
• Gamma butyrolactone (GBL) and 1,4
butanediol (BD) are structurally similar
http://www.drugabuse.gov/drug-guide/k2-spice
Ketamine
• Dissociative anesthetic with hallucinogenic
properties
– Chemical cousin of PCP
• Street names: Cat Valium, Kit Kat, Special K
• Drug facilitated sexual assault
• Prescription solution for injection
– Tablets in other countries
• Controlled substance (CIII)
Smith KM et al. Am J Health-Syst Pharm 2002; 1067-76.
Ketamine
• Swallowed, snorted or injected
• Dizziness, sedation, hypersalivation
• Respiratory depression, seizures, cardiac
arrest
• Acute Treatment Considerations:
– Support vitals
– Reduce stimuli
http://www.drugabuse.gov/publications/drugfacts/synthetic-cathinones-bath-salts
Synthetic Cathinones
• Extreme agitation, aggressive behavior and
paranoia
• Tachycardia, anxiety, tremor, hypertension,
hyperthermia
• Acute Treatment Considerations:
– Minimize stimuli
– Prepare to control agitation
– Support vitals
http://www.drugabuse.gov/publications/drugfacts/synthetic-cathinones-bath-salts
The “Educated” Consumer
• Concomitant use is likely
• “Customize” the social experience
– Combinations of hallucinations, stimulation,
euphoria, etc.
– Paraphernalia as enhancements
– Attempts to combat side effects