Common Street Drugs: Phencyclidine (PCP)

First Things First (assess & treat for the following)

• Phencyclidine is a potent analgesic & dissociative anesthetic w/ hallucinogenic properties.
• Usual 5-mg doses result in lethargy, euphoria, hallucinations.
• Large doses can result in increased autonomic effects, including HTN, hyperthermia, tachycardia, seizures.
  • HTN is common. Most cases resolve in 4 hrs but may last >24 hrs. Treat symptomatic hypertensive crisis w/ IV nitroprusside.
  • Treat seizure activity w/ a benzodiazepine.
• Violent behavior & combativeness are common; control w/ haloperidol or a benzodiazepine.
• Enterohepatic/gastroenteric cycles & storage in lipids account for prolonged symptoms.