Bath salts toxicity: Difference between revisions
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**May be found under brand name Aura, Ivory wave, Vanilla sky | **May be found under brand name Aura, Ivory wave, Vanilla sky | ||
*Active ingredients vary; often contain methylenedioxyprovalerone (MDPV) or mephedrone | *Active ingredients vary; often contain methylenedioxyprovalerone (MDPV) or mephedrone | ||
*Similar effects to MDMA, cocaine, methamphetamines | *Similar effects to [[Ecstasy (MDMA)]], [[cocaine]], [[methamphetamines]] | ||
== Clinical features == | == Clinical features == | ||
Sympathomimetic | [[Sympathomimetic toxicity]] + Psychomotor agitation + [[Hallucinations]] | ||
*Sympathomimetic toxidrome | *[[Sympathomimetic toxicity|Sympathomimetic toxidrome]] | ||
**Tachycardia | **Tachycardia | ||
**Hypertension | **Hypertension | ||
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== Treatment == | == Treatment == | ||
*Benzodiazepines or haldol for agitation | *[[Benzodiazepines]] or haldol for agitation | ||
*Rapid cooling for hyperthermia | *Rapid cooling for hyperthermia | ||
*IV hydration | *IV hydration | ||
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== Disposition == | == Disposition == | ||
*Discharge if AMS and sympathomimetic symptoms resolve w | *Discharge if [[Altered Mental Status (AMS)|AMS]] and [[Sympathomimetic toxicity|sympathomimetic]] symptoms resolve w/o end-organ damage | ||
*Admit for lab abnormalities or persistent AMS | *Admit for lab abnormalities or persistent [[Altered Mental Status (AMS)|AMS]] | ||
== Sources == | == Sources == | ||
Revision as of 06:48, 5 March 2015
Background
- Found in herbal products sold under guise of "not for human consumption"
- May be found under brand name Aura, Ivory wave, Vanilla sky
- Active ingredients vary; often contain methylenedioxyprovalerone (MDPV) or mephedrone
- Similar effects to Ecstasy (MDMA), cocaine, methamphetamines
Clinical features
Sympathomimetic toxicity + Psychomotor agitation + Hallucinations
- Sympathomimetic toxidrome
- Tachycardia
- Hypertension
- Agitation
- Paranoia
- Hyperthermia
- Hallucinogenic
Diagnosis
- Diagnosis based on history and physical exam
Work-Up
- Fingerstick glucose
- Complete metabolic panel
- LFTs
- Coags
- Total CK
- Utox not helpful, usually negative
Differential Diagnosis
Sympathomimetics
- Cocaine
- Amphetamines
- Synthetic cathinones (khat)
- Ketamine
- Ecstasy (MDMA)
- Synthetic cannabinoids
- Bath salts
Treatment
- Benzodiazepines or haldol for agitation
- Rapid cooling for hyperthermia
- IV hydration
- Monitor urine output
Disposition
- Discharge if AMS and sympathomimetic symptoms resolve w/o end-organ damage
- Admit for lab abnormalities or persistent AMS
Sources
- UpToDate
- EMRAP