Generation Z: Adolescent Xenobiotic Abuse in the 21st Century.
NMDA receptor antagonists include the prescription medication ketamine, the illicit xenobiotics PCP, MXE, and other novel PCP analogs, and the OTC medication DXM. The NMDA receptor antagonist most commonly abused by adolescents in the United States is DXM. These xenobiotics cause dissociative effects by non-competitively inhibiting the action of glutamate at the NMDA receptor. Additionally, these agents modulate the actions of monoamine neurotransmitters, agonize opioid receptors, and inhibit nitric oxide synthase. Patients typically present with sympathomimetic and neuropsychiatric clinical manifestations after abuse of NMDA receptor antagonists. Treatment is generally symptomatic and supportive. Interventions include benzodiazepines, propofol, fluids, antiemetics, aggressive cooling, and respiratory support.
William
W
Eggleston
Christine
C
Stork
D000293:Adolescent; D019969:Amphetamine-Related Disorders / Q000175:diagnosis / Q000628:therapy; D002186:Cannabinoids / Q000009:adverse effects; D000697:Central Nervous System Stimulants / Q000009:adverse effects; D015198:Designer Drugs / Q000009:adverse effects*; D003913:Dextroamphetamine / Q000009:adverse effects; D003915:Dextromethorphan / Q000009:adverse effects; D018691:Excitatory Amino Acid Antagonists / Q000009:adverse effects; D006213:Hallucinogens / Q000009:adverse effects; D006801:Humans; D058545:Inhalant Abuse / Q000175:diagnosis / Q000628:therapy; D007649:Ketamine / Q000009:adverse effects; D008774:Methylphenidate / Q000009:adverse effects; D018817:N-Methyl-3,4-methylenedioxyamphetamine / Q000009:adverse effects; D010623:Phencyclidine Abuse / Q000175:diagnosis / Q000628:therapy; D016194:Receptors, N-Methyl-D-Aspartate / Q000037:antagonists & inhibitors; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000628:therapy; D015262:Xenobiotics
D002186:Cannabinoids; D000697:Central Nervous System Stimulants; D015198:Designer Drugs; D018691:Excitatory Amino Acid Antagonists; D006213:Hallucinogens; D016194:Receptors, N-Methyl-D-Aspartate; D015262:Xenobiotics; D008774:Methylphenidate; D007649:Ketamine; D003915:Dextromethorphan; D018817:N-Methyl-3,4-methylenedioxyamphetamine; D003913:Dextroamphetamine