Comprehensive exams for Mental Health Q 192
Jeremy is brought to the emergency room by friends who state that he took something an hour ago. He is actively hallucinating, agitated, with irritated nasal septum.
A. Heroin
B. Cocaine
C. LSD
D. Marijuana
Correct Answer: B. Cocaine
The manifestations indicate intoxication with cocaine, a CNS stimulant. CNS reactions may be excitatory then depressant. In its mild form, the patient may display anxiety, restlessness, and excitement. Full-body tonic-clonic seizures may result from moderate to severe CNS stimulation. These seizures are often followed by CNS depression, with death resulting from respiratory failure and/or asphyxiation if concomitant emesis is present.
Option A: Intoxication with heroine is manifested by euphoria then impairment in judgment, attention and the presence of pupillary constriction. The intended effects of heroin misuse are those classically associated with any opioid effects. These are analgesia, euphoria, and often alleviation of opioid withdrawal symptoms. All other effects of heroin could be considered adverse. Respiratory depression is likely the most concerning adverse effect, leading to death in an increasing number of misusers. The extreme physiologic dependence also represents a major concern in those who misuse heroin.
Option C: Intoxication with hallucinogen like LSD is manifested by grandiosity, hallucinations, synesthesia, and increase in vital signs. Adverse effects are extremely subjective, with significant variability and unpredictability. One patient may experience a positive effect filled with bright hallucinations, sights and sensations, increased awareness owing to mind expansion, and marked euphoria. The positive spectrum of effects is colloquially called a “good trip.”
Option D: Intoxication with Marijuana, a cannabinoid is manifested by sensation of slowed time, conjunctival redness, social withdrawal, impaired judgment, and hallucinations. The most common emergency caused by marijuana ingestion is a panic attack. Other common adverse effects include dizziness, dry mouth, nausea, disorientation, euphoria, confusion, sedation, increased heart rate, and breathing problems. Marijuana is classified as a Schedule I substance by the FDA, and therefore is not accepted for medical use and has a high abuse potential from a federal point of view. As a result, doctors cannot prescribe marijuana, but in states that allow its use to treat medical conditions, doctors may be able to certify its use.