Podcast 539 Coricidin Abuse

>> YOUR LINK HERE: ___ http://youtube.com/watch?v=46OlVlFgSM8

Contributor: Rachel Beham, PharmD • • Educational Pearls: • • 1. Coricidin HBP Cough amp; Cold (dextromethorphan and chlorpheniramine) is one of the more commonly abused over-the-counter medications • 2. Dextromethorphan, binds to multiple receptors, particularly at high doses • Opioid receptors, causing respiratory depression, CNS depression • NMDA receptors, causing agitation and hallucinations • Serotonin-reuptake inhibition, which may lead to serotonin syndrome, especially when combined with other agents • 3. Dextromethorphan also contains bromide, which when chronically abused can lead to bromism (behavioral changes, hallucinations, weight loss, and neurologic changes) • 4. Chlorpheniramine is an antihistamine and can cause anticholinergic effects in overdose, such agitation, hyperthermia, and hallucinations • 5. Acute treatment of Coricidin abuse is mostly supportive, which may include benzodiazepines, naloxone, dialysis, sodium bicarbonate, and physostigmine depending on the predominate toxidrome and symptoms present • • References • • Ritter D, Ouellette L, Sheets JD, Riley B, Judge B, Cook A, Houseman J, Jones JS. Robo-tripping : Dextromethorphan toxicity and abuse. Am J Emerg Med. 2019 Nov 17. pii: S0735-6757(19)30655-2. doi: 10.1016/j.ajem.2019.10.001. • • Bryner JK, Wang UK, Hui JW, Bedodo M, MacDougall C, Anderson IB. Dextromethorphan abuse in adolescence: an increasing trend: 1999-2004. Arch Pediatr Adolesc Med. 2006;160(12):1217–1222. doi:10.1001/archpedi.160.12.1217 • • Monks S, Yen M, Myers J. Bromism: An overlooked and elusive toxidrome from chronic dextromethorphan abuse. Am J Emerg Med. 2019 Nov 15:158491. doi: 10.1016/j.ajem.2019.158491. • • Summarized by Will Dewispelaere, MS4 | Edited by Erik Verzemnieks, MD • The Emergency Medical Minute is excited to announce that we are now offering AMA PRA Category 1 credits™ via online course modules. To access these and for more information, visit our website at https://emergencymedicalminute.org/cm... and create an account. • Donate to EMM today: https://www.paypal.com/donate/?token=... • Episode Link on Website: https://emergencymedicalminute.org/po...

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