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Lookup NU author(s): Dr Simon Hill, Professor Simon ThomasORCiD
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© 2016 Elsevier Ltd. All rights reserved.Toxicity related to drug misuse is a common reason for hospital presentation. The recent emergence of substantial numbers of novel psychoactive substances has made management more challenging because the exact constituents of branded products containing these may not be known and, when it is, the information available about clinical features and the management of toxicity is limited. Drugs of misuse are usefully classified by their primary clinical effects. Depressants including opioids, benzodiazepines and gamma-hydroxybutyrate cause sedation with depressed tendon reflexes. Commonly encountered stimulants are cocaine, amphetamines, methylenedioxymethamphetamine ('ecstasy'), cathinones (e.g. mephedrone), piperazines, piperidines and NBOMe compounds. Typical effects include tachycardia, hypertension, mydriasis, agitation and seizures. Examples of hallucinogens are synthetic cannabinoid receptor agonists, tryptamines (e.g. alpha methyltryptamine) and ergolines (e.g. lysergic acid diethylamide); some of these also have stimulant effects. The arylcyclohexamines ketamine and methoxetamine have dissociative actions. As well managing acute toxicity, blood-borne infections, sepsis and thrombosis arising from parenteral drug use should be treated. Longer term interventions are also needed to address drug use and the social and mental health issues that commonly co-exist.
Author(s): Hill SL, Thomas SHL
Publication type: Article
Publication status: Published
Journal: Medicine
Year: 2016
Volume: 44
Issue: 3
Pages: 160-169
Print publication date: 01/03/2016
Online publication date: 08/02/2016
Acceptance date: 01/01/1900
ISSN (print): 1357-3039
ISSN (electronic): 1878-9390
Publisher: Elsevier Ltd
URL: https://doi.org/10.1016/j.mpmed.2015.12.030
DOI: 10.1016/j.mpmed.2015.12.030
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