Dextromethorphan Toxicity

Excerpt

Dextromethorphan is a drug used in many over-the-counter cough and cold medicines for its antitussive effects. It comes in oral strips, lozenges, liquids, or liquid-filled capsules and formulations often combine the drug with guaifenesin, acetaminophen, and pseudoephedrine. Dextromethorphan is also a commonly abused drug because of its euphoric, hallucinogenic, and dissociative properties. Some street names for dextromethorphan are “Triple C,” “Dex,” “Orange Crush,” “Red Devils,” and “Poor Man’s PCP.” Depending on the amount ingested, dextromethorphan toxicity can have a wide range of cardiovascular, neurological, metabolic, and musculoskeletal adverse effects. Emergency department providers should become familiar with how to manage patients with dextromethorphan toxicity since hypertension, seizures, tachycardia, psychosis, and rhabdomyolysis are several of the complications that can arise.