Download Poisoning from Illicit Human Drugs: Depressants

Poisoning from Illicit Human
Drugs: Depressants
Petra A. Volmer, DVM, MS, DABVT, DABT
BASIC INFORMATION
Animal exposures to illicit drugs are uncommon but are usually emergency situations when they do occur. In most cases,
ingestion of the owner’s prescription products occurs; however,
drugs manufactured in clandestine laboratories may also be consumed. Most street drugs contain impurities that can confuse the
diagnosis. In many instances, animal caretakers are reluctant to
provide information surrounding the exposure. In general, the
most common drugs of abuse are the depressants (barbiturates,
benzodiazepines, marijuana), opioids, and stimulants (amphetamines and cocaine).
BARBITURATES
Description
Sources of barbiturates include amobarbital (Amytal ), aprobarbital
(Alurate), butabarbital (Busodium, Butalan, Butisol ), mephobarbital (Mebaral ), pentobarbital (Nembutal ), phenobarbital (Solfoton,
Luminal, Barbita), and secobarbital (Seconal ). Barbiturates are
controlled substances whose distribution is regulated by the U.S.
Drug Enforcement Administration (DEA). Street names include
barbs, downers, red devils, goof balls, yellow jackets, block busters, pinks, reds and blues, and Christmas trees. Secondary poisoning can occur from ingestion of carcasses of animals euthanized
with pentobarbital.
Causes and Toxicity
The principal effect of barbiturates is depression of the central nervous system, especially the brain.
Clinical Signs
Barbiturates cause weakness, drowsiness, incoordination, and, in
severe cases, coma, depression of respiration (diminished breathing), and death.
Diagnostic Tests
Diagnosis is based on a history of exposure and compatible clinical signs. Barbiturates can be detected in stomach contents, blood,
urine, and feces; however, testing must be performed at outside
laboratories.
Treatment Options
If exposure was recent and the animal is not showing any clinical
signs, vomiting can be induced under the direction of a veterinarian. Your veterinarian may administer activated charcoal to help
bind the barbiturate in the gut and prevent its absorption into the
body. For severe ingestions, the animal may be hospitalized for
monitoring of the heart and lungs, as well as administration of
intravenous fluids and supportive care.
Prognosis
For animals with recent ingestions that are treated rapidly, the
prognosis is good.
BENZODIAZEPINES
Description
Benzodiazepines are prescription antianxiety, anticonvulsant, and
sedative drugs. They are controlled substances, whose distribution
is regulated by the DEA. Common names include lorazepam
(Ativan), clorazepate (Tranxene), prazepam (Centrax), clonazepam
(Klonopin), flurazepam (Dalmane), triazolam (Halcion), chlordiazepoxide (Librium), halazepam (Paxipam), temazepam (Restoril),
oxazepam (Serax), diazepam (Valium), and alprazolam (Xanax).
Flunitrazepam (Rohypnol) is referred to as the date rape drug; it is
illegal in the United States. Some street names include downers, V
(for valium), rophies, roofies, roach, and rope (flunitrazepam).
Causes and Toxicity
Benzodiazepines bind to receptors in the brain and cause central
nervous system (mental) depression. Benzodiazepines have a wide
margin of safety between doses that cause drowsiness and doses
that are lethal.
Clinical Signs
Low doses can cause weakness, disorientation, and depression. At
higher doses, vocalization, restlessness, tremors, and seizures are
possible.
Diagnostic Tests
Diagnosis is based on a history of exposure and consistent clinical
signs. Analysis of urine or blood for benzodiazepines can be performed by an outside laboratory.
Treatment Options
Animals exhibiting signs must be monitored and protected from
injury (such as falling downstairs or off furniture). Your veterinarian may recommend induction of vomiting if the exposure was
recent and a large amount of drug was ingested. Activated charcoal
may be administered to bind with the drug and prevent its absorption into the body. For severe exposures, hospitalization may be
required for administration of intravenous fluids and supportive
care. Flumazenil (Romazicon), an antidote for the benzodiazepines,
may be administered in severe cases if it is available.
Prognosis
Prognosis for most benzodiazepine ingestions is good.
MARIJUANA
Description
All parts of the marijuana plant (Cannabis sativa) are toxic.
Marijuana is available as the dried herb, a resin (hash or hashish),
or a sticky liquid (hash oil). Street names include hemp, pot, grass,
Mary Jane, sinsemilla, hash, hashish, Bhang, Ganja, charas, Thai
stick, reefer, and wacky-backy.
Continued
Copyright © 2011 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Poisoning from Illicit Human
Drugs: Depressants—cont’d
Petra A. Volmer, DVM, MS, DABVT, DABT
Causes and Toxicity
The toxic constituents in marijuana act on the brain and influence
the interpretation of stimuli from sensory organs. A wide margin
of safety exists between doses that cause early behavioral effects
and doses that are lethal.
Clinical Signs
Affected animals may be restless, nervous, and disoriented.
Vomiting, diarrhea, tremors, incoordination, weakness, and dilated
pupils may occur. Signs may last 18-72 hours.
Treatment Options
Induction of vomiting may be recommended, and activated charcoal may be administered following large ingestions. Animals
showing signs should be protected from injury (such a falling off
furniture) and given supportive care.
Prognosis
Prognosis in most cases is excellent, with most effects being
temporary.
Diagnostic Tests
Diagnosis is based on a history of exposure and compatible clinical signs. Marijuana compounds may be detected in urine.
IF SPECIAL INSTRUCTIONS HAVE BEEN ADDED, THEY WILL APPEAR ON THE LAST PAGE OF THE PRINTOUT.
Copyright © 2011 by Saunders, an imprint of Elsevier Inc. All rights reserved.