Presentation
Most patients presenting to the ED with PCP intoxication do well and can be discharged home after a period of observation. [ncbi.nlm.nih.gov]
Most patients present with the classic toxidrome of violent behavior, nystagmus, tachycardia, and hypertension. [shmabstracts.org]
Case presentation: Toxicity from PCP is dose dependent with various levels of CNS excitement based on the dose. We describe a case of a patient who presented to the emergency department with cardiac arrest. [longdom.org]
Entire Body System
- Fever
Fever, tachycardia and hypertension were frequent findings among the 25 patients with rhabdomyolysis and all had leukocytosis. The data show that rhabdomyolysis with and without acute renal failure is not infrequent among abusers of PCP. [ncbi.nlm.nih.gov]
Exam notable for fever 103F, heart rate 110 beats/min, BP 160/90mmHg, respiratory rate 22 breaths/min, O2 saturation 98%. Pupils were 3mm and reactive to light, no nystagmus. [shmabstracts.org]
Fever, tachycardia and hypertension were frequent findings among the 25 patients with rhabdomyolysis and all had leukocytosis. The data show that rhabdomyolysis with and without acute renal failure is not infrequent among abusers of PCP. © 1981 S. [karger.com]
Misuse can cause blurred vision, body itching, rash, sweating, fever, hypertension, shallow respiration, diarrhea, toxic psychosis, coma, and an increase in heart rate, blood pressure, and body temperature. [www1.nyc.gov]
Fever, tachycardia, and high blood pressure are frequent.[23] 3.2 Dose–effect relationship The 3-MeO-PCP doses and administration routes are not usually reported in the literature. [journals.lww.com]
Jaw & Teeth
- Hypersalivation
Profuse diaphoresis, hypersalivation, bronchospasm, and urinary retention occurred in less than 5%. A small percentage had severe disturbances in vital signs, including three cases (0.3%) of cardiac arrest and 28 cases (2.8%) of apnea. [ncbi.nlm.nih.gov]
Hypersalivation and lacrimation may occur. Patients may abruptly swing between quiet catatonia and loud or agitated behavior. Vertical and horizontal nystagmus may be prominent with PCP intoxication. [accessmedicine.mhmedical.com]
Cardiovascular
- Hypertension
Hypertension or tachycardia. Numbness or diminished responsiveness to pain. Ataxia. Dysarthria. Muscle rigidity. Seizures or coma. Hyperacusis. D. [dsm.wikia.org]
The prevalent clinical signs and symptoms were the following: retrograde amnesia, nystagmus, hypertension, and psychomotor agitation. Co-use of other substances was the norm. [ncbi.nlm.nih.gov]
Mild hypertension is seen in all patients with PCP intoxication. With increasing PCP dose, the panoply of sympathomimetic responses is seen; hypertensive crisis is common in association with high doses and may lead to cerebral hemorrhage. [aibolita.com]
[…] snorted, usually lasts 4-6 hours but can be longer if high dose Symptoms can fluctuate from CNS depression to excitation Wide range of symptoms due to PCP's cholinergic, anticholinergic, and sympathomimetic properties Nystagmus (very common), ataxia Hypertension [wikem.org]
- Tachycardia
Fever, tachycardia and hypertension were frequent findings among the 25 patients with rhabdomyolysis and all had leukocytosis. The data show that rhabdomyolysis with and without acute renal failure is not infrequent among abusers of PCP. [ncbi.nlm.nih.gov]
Hypertension or tachycardia. Numbness or diminished responsiveness to pain. Ataxia. Dysarthria. Muscle rigidity. Seizures or coma. Hyperacusis. D. [dsm.wikia.org]
Physical symptoms of PCP abuse include tachycardia and hypertension caused by overstimulation of the sympathetic system. PCP abuse may induce psychobehavioral symptoms such as delirium. [picmonic.com]
He developed high blood pressure (158/131 mm Hg), tachycardia (100 bpm), and neurological manifestations (confusion, hypertonia, nystagmus, and then agitation). [hal-univ-rennes1.archives-ouvertes.fr]
Musculoskeletal
- Muscle Twitch
QID: 205717 Miosis, drowsiness, constipation Disorientation, hallucinations, hostility Amnesia, ataxia, stupor, somnolence Hyperphagia, hypersomnolence, fatigue Restlessness, diuresis, muscle twitching, cardiac arrhythmias L 1 B Select Answer to see Preferred [step1.medbullets.com]
Caffeine Mechanism adenosine antagonist → decreased GABA activity (wakefulness) Intoxication presentation restlessness, insomnia diuresis muscle twitching cardiac arrhythmias treatment no specific treatment symptomatic treatment only Withdrawal presentation [medbullets.com]
twitches.[19] Our patient did not report hallucinations or delusions but he was not specifically questioned about the presence or absence of these symptoms. [journals.lww.com]
Much less common are physical symptoms such as gastrointestinal distress, diaphoresis, chills, nausea, shakiness, muscle twitches, and increased blood pressure ( 102 ). [basicmedicalkey.com]
Eyes
- Miosis
QID: 205717 Miosis, drowsiness, constipation Disorientation, hallucinations, hostility Amnesia, ataxia, stupor, somnolence Hyperphagia, hypersomnolence, fatigue Restlessness, diuresis, muscle twitching, cardiac arrhythmias L 1 B Select Answer to see Preferred [step1.medbullets.com]
Other findings less frequent but still suspect are opisthotonos, hypertension, tachypnea or hyperpnea, miosis, hyperreflexia, hypertonia, and rigidity. Once suspected, the diagnosis is most easily made by finding PCP in the urine. [journals.sagepub.com]
- Lacrimation
Hypersalivation and lacrimation may occur. Patients may abruptly swing between quiet catatonia and loud or agitated behavior. Vertical and horizontal nystagmus may be prominent with PCP intoxication. [accessmedicine.mhmedical.com]
Psychiatrical
- Euphoria
Within one hour, at least two of the following psychological symptoms: euphoria psychomotor agitation marked anxiety emotional lability grandiosity sensation of slowed time synesthesias D. [dsm.wikia.org]
Minor patterns included lethargy or stupor (38 cases; 3.8%), and combinations of bizarre behavior, violence, agitation, and euphoria in patients who were alert and oriented (325 cases; 32.5%). [ncbi.nlm.nih.gov]
Symptoms and Signs Intoxication, characterized by a giddy euphoria, occurs with lower doses; euphoria is often followed by bursts of anxiety or mood lability. [merckmanuals.com]
- Fear
NOTHING – other than the fear of "taking a stand" – prevented these authors from offering a CONCLUSION strong enough to help to make a difference and save some lives. [charlydmiller.com]
Shelby told investigators that Crutcher refused repeated requests to stop and get on his knees and that she feared for her life, believing Crutcher was going to kill her, according to an affidavit filed with the manslaughter charge. [cbsnews.com]
Here are some of the behavioral signs of PCP intoxication: “Poor perception of time and distance” Confusion Agitation Terror Panic Randomness in thought and action Severe anxiety and fear Mood swings Hostile and violent behavior PCP is increased in its [phencyclidine.org]
Such a NDE often results loss of the fear of death and a renewed interest in life. Production of artificial NDE's by ketamine has similarly been found effective to decrease an unatural fear of death. [lycaeum.org]
Common effects of PCP include hallucinations, relaxation, drowsiness, difficulty concentrating, anxiety, intense fear and suicidal behavior, as well as distorted sense of time, paranoia, rapid mood swings, and dissociation with the environment. [hallucinogens.com]
- Aggressive Behavior
Symptoms in 11 patients suspected of phencyclidine intoxication included violent, aggressive behavior with delusions, hallucinations, agitation, and other signs of toxic psychosis. [ncbi.nlm.nih.gov]
Belligerent and aggressive behavior occurs toward the abuser as well as others. Feelings of homicidality may develop. Psychomotor agitation caused by PCP ingestion results in impaired motor function. [picmonic.com]
The most important approach to management of agitated behavior is the implementation of safe physical restraints and chemical sedation. Benzodiazepines are usually effective in managing aggressive behavior. [emedicine.medscape.com]
Hallucinations, euphoria, and suicidal impulses are also reported, as well as occasional aggressive behavior. [wiki.tripsit.me]
Neurologic
- Agitation
Psychomotor agitation caused by PCP ingestion results in impaired motor function. Individuals abusing PCP may experience feelings of enhanced strength and endurance. [picmonic.com]
Within one hour, at least two of the following psychological symptoms: euphoria psychomotor agitation marked anxiety emotional lability grandiosity sensation of slowed time synesthesias D. [dsm.wikia.org]
The prevalent clinical signs and symptoms were the following: retrograde amnesia, nystagmus, hypertension, and psychomotor agitation. Co-use of other substances was the norm. [ncbi.nlm.nih.gov]
- Seizure
Higher doses produce amnesia and coma, with analgesia sufficient for surgery, and seizures with respiratory depression occur at the highest doses. [dsm.wikia.org]
PCP may cause seizures, muscle rigidity, and ultimately death. [picmonic.com]
Motor signs included grand mal seizures, generalized rigidity, localized dystonias, catalepsy, and athetosis. Profuse diaphoresis, hypersalivation, bronchospasm, and urinary retention occurred in less than 5%. [ncbi.nlm.nih.gov]
- Nystagmus
Clinical findings were the following: retrograde amnesia in 46 (25 %), horizontal nystagmus in 118 (64.1 %), vertical nystagmus in 90 (48.9 %), hypertension in 87 (47.3 %), and agitation in 71 (38.6 %). [ncbi.nlm.nih.gov]
Nystagmus and bizarre and violent behavior may distinguish intoxication due to phencyclidine from that due to other substances. [dsm.wikia.org]
PCP abuse lead to physical symptoms such as vertical or horizontal nystagmus, or involuntary eye movement that rotates the eyes sideways or up-and-down. [picmonic.com]
On examination, the patient is combative with slurred speech and active visual hallucinations; eye examination shows prominent vertical nystagmus. [step1.medbullets.com]
- Confusion
Someone high on PCP may show signs of confusion and poor perception. PCP is a “bitter-tasting, white crystalline powder that is easy to dissolve in water or alcohol” ( NDIC ). [phencyclidine.org]
- disorientation, confusion without hallucinations, hallucinations or delusions, a catatonic-like syndrome, and/or coma) that develops during, or shortly after ingestion.[1] Epidemiology Prognosis Risk Factors Criterion A Recent use of phencyclidine [psychdb.com]
Signs of Phencyclidine Intoxication These are some of the common signs and symptoms of phencyclidine (PCP) intoxication: Desire to undress Belligerent behavior Hallucinations Confusion, amnesia Besides the obvious dangers of the above symptoms of being [gomentor.com]
With higher doses, symptoms can progress to sweating, tremors, confusion, hyperactivity, seizures, stroke, cardiac arrhythmias, and sudden death. At high doses of PCP, there is a drop in blood pressure, pulse rate, and respiration. [usmleforum.com]
Bäckberg et al[10] observed confusion, disorientation, dissociation, and/or hallucinations in 4 of their patients. [journals.lww.com]
- Amnesia
The prevalent clinical signs and symptoms were the following: retrograde amnesia, nystagmus, hypertension, and psychomotor agitation. Co-use of other substances was the norm. [ncbi.nlm.nih.gov]
QID: 205717 Miosis, drowsiness, constipation Disorientation, hallucinations, hostility Amnesia, ataxia, stupor, somnolence Hyperphagia, hypersomnolence, fatigue Restlessness, diuresis, muscle twitching, cardiac arrhythmias L 1 B Select Answer to see Preferred [step1.medbullets.com]
Signs of Phencyclidine Intoxication These are some of the common signs and symptoms of phencyclidine (PCP) intoxication: Desire to undress Belligerent behavior Hallucinations Confusion, amnesia Besides the obvious dangers of the above symptoms of being [gomentor.com]
Anxiety, depression, and amnesia are also symptoms of psychosis induced by PCP ingestion. High doses of PCP affects the central nervous system and mental status. PCP abuse may lead to seizures, coma, and ultimately death. [picmonic.com]
Medical and law enforcement personnel remember the symptoms of PCP intoxication by using the mnemonic device RED DANES, which stands for: rage, erythema (skin redness), dilated pupils, delusions, amnesia, nystagmus (oscillation of the eyeball when moving [summitmalibu.com]
Workup
Proper diagnosis of PCP intoxication is important to ensure that rapid, appropriate treatment is given, costly diagnostic workups are avoided, and family evalua tions are instituted. [journals.sagepub.com]
Urine Toxicology and Laboratory Testing Generally when a patient appears to have PCP intoxication, regular laboratory workup should include renal function, fluid balance, electrolyte abnormalities, hypoglycemia, lactic acidosis, serum creatine phosphokinase [theravive.com]
Treatment
They also know about the various treatment options that are available - like psychotherapy and counseling. Unlike some others, they offer online treatment for help with an addiction to PCP. [gomentor.com]
Abstract The history, symptoms, diagnosis and treatment of phencyclidine hydrochloride (PCP) intoxication and the pharmacology of PCP are reviewed. [ncbi.nlm.nih.gov]
Pharmacologic treatment has focused more on long-term treatment of addiction than on short-term treatment of acute withdrawal ( 59, 60 ). [basicmedicalkey.com]
Treatment. Treatment of PCP intoxication aims to reduce sys Temic PCP levels and to address significant medical, behavioral, and psychiatric issues. [aibolita.com]
Prognosis
- disorientation, confusion without hallucinations, hallucinations or delusions, a catatonic-like syndrome, and/or coma) that develops during, or shortly after ingestion.[1] Epidemiology Prognosis Risk Factors Criterion A Recent use of phencyclidine [psychdb.com]
Course and Prognosis. Complete recovery from PCP intoxication is the rule in the absence of major medical complications. [aibolita.com]
Prognosis Relapse and return to PCP use is common, even among people who have experienced severe medical and psychiatric complications from the drug. [minddisorders.com]
Even patients with confirmed acute myocardial infarction have a favorable prognosis, possibly because of their relatively young age and good underlying health ( 42 ). [basicmedicalkey.com]
Etiology
Conclusions: Altered mental status with catatonia seen in the hospital can have a psychiatric or medical etiology. Substance intoxication should be recognized as a cause in the right clinical context. [shmabstracts.org]
Psychiatric symptoms that persist beyond a few days suggest an etiology other than stimulant use ( 24, 33, 34 ). Transient psychotic symptoms during periods of abstinence (“flashbacks”) have been reported among methamphetamine users ( 35 ). [basicmedicalkey.com]
Epidemiology
- disorientation, confusion without hallucinations, hallucinations or delusions, a catatonic-like syndrome, and/or coma) that develops during, or shortly after ingestion.[1] Epidemiology Prognosis Risk Factors Criterion A Recent use of phencyclidine [psychdb.com]
There were no signs of liver or kidney failure (serum creatinine: 73 μmol/L; estimated glomerular filtration rate calculated according to the Chronic Kidney Disease Epidemiology Collaboration equation: 130 mL/minute/1.73 m2; prothrombin ratio: 99%; serum [journals.lww.com]
Pathophysiology
Neurological complications of drug abuse: pathophysiological mechanisms. Eur J Neurol 2000;7:595–606; Schuckit MA. Drug and alcohol abuse. A clinical guide to diagnosis and treatment, 6th ed. New York: Springer, 2006; Tashkin DP. [basicmedicalkey.com]
Prevention
NOTHING – other than the fear of "taking a stand" – prevented these authors from offering a CONCLUSION strong enough to help to make a difference and save some lives. [charlydmiller.com]
Treatment and aftercare will provide the skills and support someone in recovery will need to live a life of sobriety and prevent relapse. [drugabuse.com]
Staff may administer activated charcoal to prevent further absorption of any drugs from the digestive tract into the person’s system. Treatment of any seizures. Seizures will be controlled with medications. Heart monitoring. [recovery.org]
You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week. [medlineplus.gov]
Prevention PCP intoxication and related disorders can be prevented by not using the drug. Resources BOOKS American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. text revised. [minddisorders.com]