PCP overdose

An analysis of 19 deaths from PCP overdose that occurred in two California counties from 1970 to 1976 showed that 12 were accidental, five suicidal, and two homicidal. Eight of the 12 accidental deaths were from drowning. Blood concentrations ranged from 1,250 to 2,300 ng/ml. Virtually all patients with levels of 1,000 ng/ml or more had coma, with the possible evolution of death due to medical complications, seizures, or respiratory depression. Levels greater than 2,000 ng/ml were almost always fatal (12). 

Treatment of PCP intoxication also involves limiting external stimuli, minimizing lighting, noise, and unnecessary physical contact. The life-threatening nature of PCP overdose, however, may require symptomatic treatment of respiratory depression by artificial respiration or use of neuroleptics to control violent rage or panic anxiety. 

Urine pH is an important determinant of renal elimination of PCP. In a study in which urine pH was uncontrolled (6.0 to 7.5), the average total clearance of PCP was 22.8 4.8 L/h after intravenous administration.4 In the same study, renal clearance was 1.98 0.48 L/h. When the urine was made alkaline, the renal clearance of PCP was found to decrease to 0.3 0.18 L/h. If the urine was acidified (pH 6.1) in the same subjects, renal clearance increased to 2.4 0.78 L/h.13 Aronow et al.14 determined that if the urine pH was decreased to <5.0, renal clearance increased significantly to 8.04 1.56 L/h. There is disagreement about the utility of urine acidification in the treatment of PCP overdose, even though excretion may be increased by as much as 100-fold.15 It should be noted that acidification may increase the risk of metabolic complications.16... 

A PCP overdose can lead to death if not adequately treated, so people who overdose on PCP should immedi-... 

Patients with the lethargy pattern of PCP toxicity may be clinically indistinguishable from patient with mild sedative/hypnotic intoxication, although hypertension and grand mal seizures which may occur with PCP intoxication, are not expected with sedative/ hypnotic overdose. The remaining minor patterns are differentiated as follows. 

Deaths from overdoses of other types of hallucinogens are rare, but not with PCP. Poisoning with this drug is a major medical emergency and requires great skill in management. Fortunately, the means are available for successful treatment. 

The laboratory operator, when he woke up, was arrested, and is now awaiting trial in Montgomery County charged with the illegal manufacture of PCP. (As it turned out, he was found to be suffering from an overdose of a drug prescribed by his doctor.)... 

This book will focus on forensic pharmacology and drugs of abuse. Drugs of abuse, such as cocaine, heroin, marijuana, PCP, benzodiazepines, and methamphetamine, are often involved in criminal and civil matters concerning personal injury, motor vehicle accidents, drug overdose, and murder, and thus, are discussed to illustrate forensic pharmacology issues and investigations. 

PCP has a sedative effect on certain systems in the body and interactions with other central nervous system depressants such as alcohol and benzodiazepines may lead to coma or accidental overdose. 

Deaths from an overdose of PCP are usually caused by respiratory arrest, but death can also result from seizures, cardiovascular collapse, and extremely high fever, which leads to kidney, liver, and brain damage. High doses of PCP also result in extremely high blood pressure, which may cause a stroke. 

People who overdose on PCP may fall into a deep coma, slowly come out of it, and then continue to have signs of mild to moderate PCP intoxication that last two to six weeks. This is one of the longest-lasting toxic reactions produced by drugs of abuse. 

For a decade after its isolation, psilocybin, mainly in the form of pills, was readily available in the United States as a pharmacological drug. It was prescribed for psychological therapy. In 1968, psilocybin was made illegal, as few positive conclusions could be drawn about its benefits. Also, it had a high incidence of abuse. Psilocybin powder is usually swallowed, injected intravenously, or sniffed. Due to its high potency, it carries a high risk of overdose. Psilocybin powder or pills are expensive and difficult to produce and therefore difficult to obtain on the street. Studies indicate that when psilocybin is sold on the street, it is usually LSD, PCP (phencyclidine), or both. 

Injecting Psilocybe mushroom juice intravenously is not common but it is reported. Most psilocybin users are seeking a natural experience and use of needles is not considered natural. Intravenous injection is the fastest means of getting psilocybin to the brain. In less than 16 seconds, the psilocybin is mixed with the blood, taken to the lungs, returned to the heart, and delivered to the brain. As the natural barriers and buffers of the stomach, small intestine, and liver are bypassed, the chances of overdose and adverse side effects such as coma, convulsions, and kidney failure, are greatly increased. It is even more rare for users to inject psilocybin powder, as this drug is difficult to obtain on the street. Supposed psilocybin powder bought on the street is almost always LSD, PCP, or both. 

PCP intoxication typically produces miosis, nystagmus, hypertension, tachycardia, salivation, flushing, sweating, ataxia, and CNS stimulation or depression. Overdose of PCP is dangerous, as the user becomes violent and emergency treatment is required. It is necessary to keep the user calm and not leave him alone. Withdrawal symptoms of PCP are tremor, seizures, diarrhea, piloerection, and vocalizations. 

The mental effects are very variable but often include a feeling of disconnection from the body and from external reality, apathy, disorganization of thinking, a druiiklikc state, and distortions of time and space perception. Overdoses can cause convulsions and coma. When it is smoked, PCP s effects come on within a few... 

Sometimes patients will report a reexpeiiendng or "flashback" of halludnations they had during a previous ingestion of halludnogen. These leadions likewise usually do not require treatment with medication but, when severe, may benefit from antianxiety or antipsychotic medication. Severe overdoses of PCP can lead to convulsions and may require emergency medical treatment. 

Aronow R, Miceli JN, and Done AK (1980) A therapeutic approach to the acutely overdosed PCP patient. Journal of Psychedelic Drugs 12 259-266. 

Boeckx RL. False positive EMIT DAU PCP assay as a result of an overdose of dextromethorphan. Clin Chem 1987 33 974-5 (abstract). 

Abuse of psychoactive chemicals can result in neurotoxic effects that are difficult to treat medically. Successful therapy is often hindered by the lack of useful antagonists for many of these chemicals and by the extensive distribution of these chemicals out of the bloodstream. Although there are treatments for opiate addiction and an antagonist for opiate overdose, there are no such medical treatments for most drugs of abuse such as phencyclidine (PCP) and cocaine. Therefore, this chapter focuses on recent advances in immunotherapy which suggest this novel approach could be beneficial in the treatment of drug abuse. 

Treatment of the adverse effects of PCP is difficult for several reasons. PCP has a very high volume of distribution (6.2 liters per kilogram (L/kg) in humans) and its clearance is primarily by metabolism (Cook et al. 1982) with only a small contribution from renal excretion. Its major sites of action in the central nervous system (CNS) are far removed from the beneficial effects of most traditional treatment methods such as dialysis. In addition, there is no specific antagonist for PCP s adverse effects. These pharmacokinetic and receptor-medicated characteristics make it very difficult to develop effective treatment strategies. Some of the current methods for treatment of overdose are urine acidification, diazepam administration to control convulsions (Aronow and Done 1978 ... 

PCP (phencyclidine), an anitpal tranquilizer, is often sold on the street in capsules or tablet a[s "THC," and falsely believed to be synthetic marijuana, wn t believe it for a minute. Real THC is much too expensive to produce or market for street use. PCP is also sprayed on parsley, catnip, mint leaves or weak marijuana and sold as "angel dust or "super grass." PCP has an extraordinarily high bummer potential, and in addition can cause an overdose if taken in too great an amount, or In concert with alcohol, barbiturates, methaqualone, etc. 

Another use for PCP seems to be as an additive to real psychedelics, to create phony "mescaline" or phony "psilocybin. Recent analysis has indicated PCP, speed and low-grade acid being sold as mescaline. If you try PCP and nothing seems wrong, our best advice is Be careful. This is a dangerous drug with high bummer potential, and overdose potential even when smoked ... 

PCP extremely toxic, horizontal and vertical nystagmus, paranoia, rhabdomyolysis overdose is common, with convulsions and death... 

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