Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + Download Section PDF Listen ++ For further information, see CMDT Part 38-41: LSD & Other Hallucinogens Overdose + Key Features Download Section PDF Listen +++ ++ The mechanism of toxicity and the clinical effects vary for each substance + Clinical Findings Download Section PDF Listen +++ ++ Anticholinergic delirium Dilated pupils Flushed skin Dry mucous membranes Tachycardia Urinary retention LSD Marked visual hallucinations and perceptual distortion Widely dilated pupils Mild tachycardia Phencyclidine (PCP) can produce fluctuating delirium and coma, often with vertical and horizontal nystagmus Toluene and other hydrocarbon solvents (eg, butane, trichloroethylene) Euphoria Delirium Potentially fatal dysrhythmias Other drugs used for their psychostimulant effects include Synthetic cannabinoid receptor agonists Salvia divinorum Synthetic tryptamines and phenylethylamines Mephedrone and related cathionone derivatives + Treatment Download Section PDF Listen +++ ++ For recent ingestions, administer activated charcoal, 60–100 g orally or via gastric tube, mixed in aqueous slurry Treat anticholinergic delirium with physostigmine salicylate, 0.5–1.0 mg intravenously, not to exceed 1 mg/min Caution: Bradyarrhythmias and convulsions can occur with physostigmine use Treat dysphoria, agitation, or psychosis from LSD or mescaline intoxication with Lorazepam, 1–2 mg orally or intravenously Haloperidol, 2–5 mg intramuscularly or intravenously Another antipsychotic drug (eg, olanzapine or ziprasidone) Monitor patients who have sniffed solvents for cardiac dysrhythmias; beta-blockers (eg, propranolol, 1–5 mg intravenously, or esmolol, 250–500 mcg/kg intravenously, then 50 mcg/kg/min by infusion) may be used