Cytat:Mr. A, a 22-year-old Hispanic male with past psychiatric history of methamphetamine dependence and bipolar disorder type 1, came to the emergency department because of suicidal ideation with a plan to slash his throat with a machete. The patient was very agitated in triage and during initial assessment. In the emergency room (ER), the patient reported that he had been using methamphetamine for the last two years. His last use was a few hours before coming to the ER and that was his only use during the past six to eight weeks.

(...)

The patient was transferred to the inpatient psychiatry unit. The next day, the patient was disoriented, refused to talk to the treatment team, and slept most of the day. On his third hospital day, the patient was much more oriented and reported that he was unable to get methamphetamine for the past six to eight weeks because he could not afford it. He claimed to use an insecticide, mostly cockroach killer, to “get high.” He would either “electrocute” the bottle or spray it on a heated metal sheet, and when the contents of the bottle turned into crystal, he would either inhale it or smoke it. The patient would use the crystals formed from one bottle for four to seven days. He claimed that his friends used those crystals intravenously after diluting them. The patient reported that it would give him the same high as methamphetamine and he would occasionally have feelings of deja vu. The patient also reported having olfactory hallucinations when he was on “crystal roach killer” but could not elaborate on that. He said that he liked the increase in heart rate and the “rush” he used to get after every use.

The patient's last use of the “crystal roach killer” was three days before coming to the ER. The patient reported that he would sleep most of the day when he was using it. He denied unwanted adverse effects during his use except for frequent headaches upon waking up which were relieved by over-the-counter analgesics. The patient had been using the insecticide for six to eight weeks and only used methamphetamine one (1) day before coming to the ER. The patient claimed that he had been compliant with his medications for bipolar disorder until he started using “crystal roach killer.” The patient was taking divalproex sodium 500 mg twice daily and quetiapine extended-release 300 mg at bedtime. He voiced that he, since a few weeks before coming to the ER, got scared that he might get cancer because of the frequent use of the insecticide, which led him to have suicidal ideation.

Cytat:Mr. W, a 56-year-old man, currently homeless, with a long history of intravenous (IV) methamphetamine use, presented to the general hospital in fulminant liver failure with a chief complaint of “I think I shot up some wasp spray.” (...) His urine toxicology screen was negative. Head, chest, and abdominal computed tomography scans had no acute findings. On physical exam, Mr. W was grossly confused and only able to state “I think I was poisoned.” He was ill-appearing and had scleral icterus. As additional laboratory data returns, Mr. W was found to be acutely positive for hepatitis A and hepatitis B.
For days 1–3 of his hospitalization, Mr. W remained confused and had an episode of agitation requiring 1 dose of 4 mg of IV haloperidol. He was diagnosed with a mixed hyper- and hypoactive delirium and required dexmedetomidine 0.2 mcg/kg/h titrated up to 1.5 mcg/kg/h for management of his symptoms. By day 4, he was weaned from dexmedetomidine as his cognitive status returned to baseline.
Mr. W reported he had been using IV methamphetamine daily up until approximately 6 days before hospitalization when he ran out due to cost. At that time, he said over the course of a day, a friend injected him 3 times with large quantities of “hot shots,” which he described as wasp spray applied to methamphetamine over a wire mesh that was connected to a portable battery. When the battery was turned on, the methamphetamine was crystallized with the wasp spray which was then injected into his veins. He reported that this was the first time he has experienced this combination and was fearful of the adverse effects and said he did not intend on using it again. He was hospitalized for 10 days to complete treatment for his liver failure from hepatitis A and B which improved with supportive care.

(16.09.2023, 19:53)Twilight Sparkle napisał(a): Może okaże się że pani w szkole nie kłamała i dopalacze naprawdę robi się z trutki na szczury i domestosa xDDDD