摘要:

Cocaine abuse is associated with a variety of severe acute neurologic complications. These include ischemic stroke, subarachnoid and intraparenchymal hemorrhage, syncope, seizures, and death. Eleven adult patients with cocaine-related seizures are reported. All were seen during the 1987 calendar year at the King/Drew Medical Center and Urban Comprehensive Epilepsy Program of Los Angeles. Three apparent clinical circumstances with defined methods of intake and time course after usage were identified in our cases. Seizures occurred 1) as acute provoked convulsions in patients known to have epilepsy, 2) spontaneously in otherwise normal individuals after acute snorting or“crack smoking,”and 3) agonally with massive ingestion.

ISSN:0095-2990    

DOI:10.3109/00952999009001592

出版商:Taylor&Francis    

年代:1990

数据来源: Taylor

摘要:

The tendency of emergency psychiatrists to make alcohol- and drug-related diagnoses was examined before and after the addition of a standardized psychoactive substance use questionnaire. The addition of the questionnaire resulted in a significant increase in the number of psychoactive-substance-induced organic mental disorder (substance-induced disorder) diagnoses. The questionnaire selectively increased the recognition of nonalcoholic substance-induced disorders while not significantly increasing the diagnoses of alcohol-induced disorders when alcohol was used alone. This suggests that nonalcoholic substance-induced disorders are underdiagnosed in emergency psychiatry. With the increase in the diagnoses of substance-induced disorders, there was a significant decrease in the frequency of psychotic disorder diagnoses and a significant increase in the frequency of adjustment disorder diagnoses. The clinical impact of underdiagnosing and misdiagnosing substance-induced disorders is discussed. Overall, the findings suggest that an increased awareness of substance use history, by the use of a standardized questionnaire, is an effective means of increasing the diagnostic yield of substance-induced disorders in the psychiatric emergency room. Follow-up studies using urine drug screening are recommended.

ISSN:0095-2990    

DOI:10.3109/00952999009001593

出版商:Taylor&Francis    

年代:1990

数据来源: Taylor

摘要:

Plasma concentrations of desipramine (DMI) and its 2-hydroxy metabolite (OHDMI) were compared among 72 patients being treated with desipramine for either depression (n = 39) or cocaine abuse(n= 33). Eleven cocaine abusers who were concurrently maintained on methadone had a significantly lower ratio of DMI dose to plasma concentration (0.9) than the depressives (2.2) or nonmethadone cocaine abusers (2.0). Their OHDMI/DMI ratios were significantly lower (0.19) than for either the other 22 cocaine abusers (0.39) or the depressed (0.50) patients. This difference was not due to DMI dosage. Although the underlying mechanism cannot be determined from these plasma studies, possible reduced hydroxylation of DMI in methadone patients suggests the need for DMI plasma monitoring.

ISSN:0095-2990    

DOI:10.3109/00952999009001594

出版商:Taylor&Francis    

年代:1990

数据来源: Taylor

摘要:

Phencyclidine (PCP) remains a widely used illicit drug, especially among adolescents and young adults. The pharmacologic effects of PCP are similar to those of cocaine; therefore, in this retrospective study 37 PCP-intoxicated parturients were matched for ethnicity, tobacco use, age, gravidity, and degree of prenatal care with 37 cocaine-intoxicated parturients. Infants exposed to PCPin uterolike those exposed to cocaine, had a high incidence of intrauterine growth retardation (32 vs 19%, N.S.), precipitate labor (43 vs 27%, N.S.), symptoms of neonatal drug withdrawal/intoxication, and prolonged neonatal hospitalizations. Moreover, they were more likely to have meconium-stained amniotic fluid (30 vs 19%,p=. 05) and less likely to be born prematurely as cocaine-exposed infants. The comparison between the long-term developmental outcome of these groups awaits further study.

ISSN:0095-2990    

DOI:10.3109/00952999009001595

出版商:Taylor&Francis    

年代:1990

数据来源: Taylor

ISSN:0095-2990    

DOI:10.3109/00952999009001596

出版商:Taylor&Francis    

年代:1990

数据来源: Taylor