Dear Sam,
Info from the Manchester area is that some clubbers have begun using
beta blockers to counter the effects of the tachy (sorry, seem to be a
bit beta blocker obsessed at present). Unlikely here as she didn't take
any commercial tabs though may have been incorp into the buccal load.
Anton
Sam Waddy wrote:
>
> Anyone any ideas:
>
> I saw a 18 year old girl who came in with headache and vomiting after
> supposedly taking 500mg-1g (max) of speed, was quite anxious and clearly
> in discomfort and distressed intermittently. Given metoclopramide,
> which fixed the vomiting. Nothing to find on examination, except,
> weirdly she only had a pulse of 60. First came in about 2-3 hours post
> drugs (taken orally as buccal "bong" I think) seen about 4 hours, went
> back to her about 6 hours to review and felt I should try to look in her
> fundi (subarachnoid crossing my colleage's mind as she wasn't improving
> much) and she fitted -- good going tonic fit, decerebrate posturing,
> urinary incontinence, went purple, starting to come out but still very
> stiff, so given PR diazepam, end of fit, no clonic phase. Sats 100%
> immediately after diazepam.
>
> She was post ictal for about 10-15 minutes then absolutely fine,
> headache gone, no nausea, stropping about going home.
>
> Three others took same lot of drugs, one with her, all were absolutely
> fine.
>
> I thought if someone was going to fit on speed they would do it within
> the first hour or so (time of max effect). Could the metoclopramide
> have contributed, clearly the irritation of fundoscopy did.
>
> Anyone any ideas for what else might be being put in speed that could
> have caused this, and particularly stopped her being tachycardic?
> --
> Sam Waddy
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