Citation

Wong GT, Irwin MG. Anaesthesia 2013; 68(Suppl 1): 117-124.

Affiliation

Clinical Assistant Professor  Professor & Head, Department of Anaesthesiology, University of Hong Kong, Hong Kong  Chief of Service, Department of Anaesthesiology, Queen Mary Hospital, HKU-Shenzhen Hospital, Hong Kong.

Copyright

(Copyright © 2013, Association of Anaesthetists of Great Britain and Ireland, Publisher John Wiley and Sons)

DOI

10.1111/anae.12053

PMID

23210561

Abstract

The consumption of illicit substances represents a considerable threat to the health and wellbeing of particular sectors of our communities. Hospitalisation is sometimes required for the treatment of the direct toxic effects of the drugs as well as for injuries sustained while under their influence. Although poisoning with 'traditional' substances of abuse such as opioids, cocaine and cannabis still predominate in terms of numbers, the availability and use of new psychoactive substances are on the rise. These latter agents, some of which began life as failed pharmaceutical products, have enjoyed renewed status as recreational stimulants, entactogens or hallucinogens, properties that originally precluded them from legitimate use. These drugs may act by enhancing endogenous release of neurotransmitters, inhibiting their reuptake back into neurons or having direct effects on receptors, and may involve adrenergic, dopaminergic or serotonergic systems. The use of intravenous lipid emulsion for the symptomatic treatment of drug overdose has become a fertile ground for research and may hold promise as a non-specific treatment for poisoning with illicit substances. Dexmedetomidine, an α(2) -receptor agonist with a central sympatholytic effect, may be able to counteract the cardiovascular and central nervous system overstimulation that may accompany stimulant toxicity.

Language: en