Cases reported "Phencyclidine Abuse"

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1/8. Legal issues associated with PCP abuse--the role of the forensic expert.

    These cases illustrate some of the complex issues associated with PCP-related litigation. The concept that malice is implied when an experienced drug user commits a crime while under the influence of the drug is not held in most states, at the present time. The authors have now reviewed in detail four cases of unexpected death following the use of neck holds in PCP-intoxicated individuals. In all of the cases, multiple carotid compression holds had been attempted, according to the history. skin abrasions, hemorrhage into the soft tissues of the neck, and fractures of the hyoid bone and thyroid cartilage provide structural evidence of the application of substantial force to the neck. On autopsy, there has been no evidence of lethal injuries to the bronchial tree, brain, or heart. Drugs related to PCP are known to alter the carotid sinus reflex. Mechanical stimulation of the carotid sinus in the neck normally results in a slowing of heart rate and a decrease in blood pressure. carotid sinus stimulation, coupled with the effects of PCP on blood vessels, might result in a marked fall in the blood pressure that could lead, ultimately, to death. Individuals intoxicated with PCP may be at a higher risk to complications of carotid compression neck holds. Hence, additional cases would be expected to become medicolegal issues.
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2/8. Pathological and radiological correlation of subarachnoid hemorrhage in phencyclidine abuse. Case report.

    Although hypertension can be associated with phencyclidine (PCP) use, subarachnoid hemorrhage (SAH) is a rare result. The radiological and pathological findings are reported of a patient with acute SAH who had chromatographic evidence of PCP in his blood. The occurrence of SAH in a patient who uses PCP may be caused by a disrupted arterial vessel wall and/or vasospasm due to the pharmacological action of the drug on the cerebral vasculature.
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3/8. PCP intoxication in seven young children.

    Five infants and two young children were treated at a large children's hospital for phencyclidine intoxication. The clinical symptoms and signs were mostly neurologic, including diminished response to tactile and verbal stimuli (100%), ataxia (71%), nystagmus (57%), constricted pupils (57%), depressed sensorium, and stupor associated with a blank, expressionless stare (57%). Notably absent were the behavioral aberrations such as aggression, which are usually seen with PCP intoxication in older children and adults. The possibility of drug intoxication was denied by most of the parents or surrogate parents accompanying these small children and infants for treatment. It is suggested that a systematic investigation for possible PCP exposure, including a urine toxicology screen for PCP (preferably by immunoassay methods), be conducted whenever an infant or child is brought for emergency treatment of unresponsiveness, bizarre behavior, dyskinesis, dystonic posturing, atypical oculomotor and pupil findings, or evidence of hallucinations.
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4/8. PCP in amniotic fluid and breast milk: case report.

    The presence of phencyclidine (PCP) in breast milk and amniotic fluid of a young drug abuser is described. Implications drawn from these data include the possible use of amniocentesis in women with well-documented histories of drug abuse who have low levels of PCP in urine, and the restriction of breast feeding in women who have abused PCP.
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5/8. Characteristics of victims of PCP-related deaths in los angeles County.

    The characteristics of the 104 persons who died in los angeles County in 1980 where PCP use was involved, have been studied. A majority of these victims were Black (73%), males (85%), in their twenties (20-29 (58%)), and the victim of a homicide (52%). In only 14% of these cases was there a fatal overdose of PCP alone or in combination with other drugs.
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6/8. Phencyclidine ingestion: drug abuse and psychosis.

    Phencyclidine (PCP) is a popular illicit drug often misrepresented as some other hallucinogenic substance and distributed in widely varying dosage forms and strengths. Users of hallucinogenic drugs may present with unintentional PCP overdoses. Toxicological laboratory analyses are essential to establish the diagnosis. In nine admitted overdose patients, the consciousness level ranged from alert to comatose on presentation, and all showed a prolonged recovery phase with agitation and toxic psychosis. Severe behavior disorder, paranoid ideation, and amnesia for the entire period of in-hospital stay are characteristic. In very high dose patients, shallow respiratory excursions and periods of apnoea and cyanosis coincided with generalized extensor spasm and spasm of neck muscles. Excessive bronchial secretions, gross ataxia, opisthotonic posturing, and grimacing occur. PCP toxic psychosis should be considered in drug-abusing patients presenting with schizophrenic-like symptoms, psychosis, or other bizarre behavior, whether or not they admit to taking PCP.
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7/8. Neonatal manifestations of maternal phencyclidine (PCP) abuse.

    Two cases concerning newborn infants whose mothers used phencyclidine (PCP) during pregnancy are described. The neonatal symptoms of maternal PCP abuse were jitteriness, hypertonicity, vomiting, and one case of diarrhea. In both infants, PCP was detected in the urine during the first few days of life. Both infants were successfully treated with phenobarbital but they continued to remain jittery and slightly hypertonic following discontinuation of the therapy. In one case the infant was noted to be microcephalic. In the neonate, the symptoms of maternal PCP abuse are similar to the symptoms of narcotic withdrawal. The diagnosis of PCP effects in the neonate can be confirmed by urinalysis for the drug. The teratogenicity of PCP remains a possibility. The metabolism and treatment of PCP effects in the newborn need further clarification.
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8/8. Application of a radioimmunoassay screening test for detection and management of phencyclidine intoxication.

    A radioimmunoassay procedure has been developed to monitor patients suspected of phencyclidine (PCP) intoxication. Symptoms in 11 patients suspected of phencyclidine intoxication included violent, aggressive behavior with delusions, hallucinations, agitation, and other signs of toxic psychosis. In five subjects serum concentrations of PCP ranged between 0.5 and 40 ng/ml. For laboratory confirmation, ascorbic acid should be administered to the patient after collecting the initial urine specimen. The initial urine and the first and second specimen after acidification should be collected and submitted for analysis. By following this provocative mobilization procedure, phencyclidine has been identified in the first or second postacidification urine when the initial specimen gave either a negative or questionable reaction. patients reporting to emergency rooms with hallucinations and psychosis and a history of "pot" smoking should be screened for the presence of phencyclidine in their blood and urine. For those cases that turn out to be negative for the phencyclidine group of compounds, other hallucinogenic drugs such as lysergic acid diethylamide, ketamine, mescaline, or psilocybin may be suspect.
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