PHENCYCLIDINE TOXICITY

Course overview

PHENCYCLIDINE (PCP) IS A DISSOCIATIVE ANESTHETIC THAT IS A COMMONLY USED RECREATIONAL DRUG. PCP IS A CRYSTALLINE POWDER THAT CAN BE INGESTED ORALLY, INJECTED INTRAVENOUSLY, INHALED, OR SMOKED. AFTER BEING DISCOVERED IN 1926, PCP WAS DEVELOPED AS A GENERAL ANESTHETIC IN THE 1950S BECAUSE IT COULD ACHIEVE ANALGESIA AND ANESTHESIA WITH MINIMAL CARDIOVASCULAR AND RESPIRATORY SUPPRESSION. IT WAS MARKETED UNDER THE NAME SERNYL. IN 1963, SERNYL BEGAN TO BE USED IN SURGICAL PROCEDURES. BY 1967, IT WAS DISCONTINUED DUE TO POSTOPERATIVE DYSPHORIA AND HALLUCINATIONS. AFTER 1967, IT WAS LIMITED TO VETERINARY USE. ALSO IN THE 1960S, PCP BEGAN TO BE ILLEGALLY MANUFACTURED IN LABORATORIES AND EMERGED AS A POPULAR STREET DRUG IN SAN FRANCISCO. IN THE 1970S, PCP USE BECAME WIDESPREAD. COMMON STREET NAMES FOR PCP ARE THE PEACE PILL, ANGEL DUST, CRYSTAL JOINTS, ROCKET FUEL, SAWGRASS, ZOOM, THE SHEETS, AND ELEPHANT TRANQUILIZER. DEPENDING ON THE DOSE AND ROUTE OF ADMINISTRATION, PCP CAN HAVE A WIDE RANGE OF CENTRAL NERVOUS SYSTEM (CNS) MANIFESTATIONS. EMERGENCY DEPARTMENT PROVIDERS SHOULD BECOME FAMILIAR WITH HOW TO MANAGE PATIENTS WITH PCP TOXICITY SINCE RHABDOMYOLYSIS, HYPOGLYCEMIA, SEIZURES, HYPERTENSIVE CRISIS, COMA, AND TRAUMA ARE SEVERAL OF THE COMPLICATIONS THAT CAN ARISE WITH PCP USE. THIS ACTIVITY DESCRIBES THE PRESENTATION OF PATIENTS WITH PHENCYCLIDINE TOXICITY AND HIGHLIGHTS THE ROLE OF THE INTERPROFESSIONAL TEAM IN THE MANAGEMENT OF THESE PATIENTS. TO IMPROVE PATIENT OUTCOMES, CLINICIANS NEED TO BE AWARE THAT MANY USERS DO NOT ONLY ABUSE ONE ILLICIT AGENT BUT MULTIPLE AGENTS. THUS, WHEN PATIENTS ARE ADMITTED WITH A DRUG OVERDOSE, A URINARY DRUG SCREEN SHOULD BE PERFORMED FOR OTHER ILLICIT AGENTS AT THE SAME TIME.