Poisoning and Overdose 241229.A 30-year-old man is brought to the ED by police officers. The
patient is agitated, vomiting, and complaining of body aches. He states that
he is withdrawing from his medication. His vital signs are BP 160/85 mm Hg,
RR 20 breaths per minute, HR 107 beats per minute, and temperature
99.7°F. On examination he is diaphoretic, has rhinorrhea, piloerection, and
hyperactive bowel sounds. Which of the following substances is this patient
most likely withdrawing from?
a. Ethanol
b. Cocaine
c. Nicotine
d. Methadone
e. Clonidine
230.A 25-year-old man is brought into the ED by two police officers because
of suspected drug use. The patient is extremely agitated and is fighting the
police officers. It takes three hospital staff members and the two police officers
to keep him on the stretcher. His vital signs are: BP 150/80 mm Hg, HR
107 beats per minute, temperature 99.7°F, RR 18 breaths per minute, and oxy-
gen saturation 99% on room air. Physical examination is unremarkable except
for cool, diaphoretic skin, persistent vertical and horizontal nystagmus, and
occasional myoclonic jerks. Which of the following is the most likely diagnosis?
a. Cocaine intoxication
b. Cocaine withdrawal
c. Amphetamine intoxication
d. PCP intoxication
e. Opiate withdrawal