A 28-year-old patient is brought to the emergency department with confusion, agitation, and hyperthermia. The patient's friends report they were at a music festival, and the patient had taken an unknown pill. Which of the following is the most likely cause of the patient's symptoms?
Cocaine overdose
Alcohol intoxication
MDMA (Ecstasy) toxicity
Opioid overdose
The correct answer is MDMA (Ecstasy) toxicity. MDMA is a common party drug that can cause a constellation of symptoms including confusion, agitation, and hyperthermia. This condition, known as serotonin syndrome, is a potentially life-threatening reaction to excessive serotonergic activity in the central nervous system.
Alcohol intoxication typically causes depressant effects and would not explain the hyperthermia. Opioid overdose usually presents with respiratory depression and pinpoint pupils, not agitation and hyperthermia. While cocaine can cause agitation and hyperthermia, it's less commonly associated with confusion and is not typically taken in pill form at music festivals.
In managing MDMA toxicity, the priority is to address hyperthermia through cooling measures and to provide supportive care. Benzodiazepines may be used to manage agitation. It's crucial for emergency nurses to recognize the signs of various substance-related emergencies to provide appropriate and timely care.
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