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Question: Tox

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You are seeing a pair of 14 year old girls who took “Triple C” at a party. One is altered and the other is hallucinating. In addition, they are tachycardic.

What is the likely active agent causing their symptoms?

pemsou5_wp • May 14, 2019

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  1. Kelly May 14, 2019 - 10:44 pm Reply

    D) Dextromethorphan
    Over the counter cough and cold products containing dextrorphan and dextromethorphan are used by adolescents to produce a high. Coricidin products are particularly high prevalence for abuse. Slang names include Triple C, DXM, Skittles, and Robo. These agents are particularly popular with younger teens as they can be bought easily over the counter and teens consider them a “safe high.” Common symptoms include tachycardia, hypertension, confusion and AMS, hallucinations, mydriasis, agitation, ataxia. While severe symptoms and fatalities are very rare, patients may undergo extensive AMS work-ups if the ingestion history is not obtained. Since these are usually ingested as OTC cough and cold products, assess for co-ingestants such as acetaminophen, antihistamines, pseudoephedrine.

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