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Table 2 Indicators of designer drug use

From: Designer drugs 2015: assessment and management

Body system

Finding

Medical indication

Drug (s)

General

Hyperthermia

Intoxication

Synthetic hallucinogens, bath salts

Head & neck

Conjunctival injection

Recent use

Synthetic cannabinoids

Smoky chemical smell on breath

Recent smoking

Any smoked designer drug

Epistaxis

Intranasal use

Bath salts, synthetic hallucinogens

Nasal septal perforation

Intranasal use

Bath salts

Poor dentition

Inadequate oral hygiene

Bath salts

Jaw clenching, teeth grinding (bruxism)

Intoxication

Bath salts

Cardiac

Tachycardia

Recent use

Any designer drug

Hypertension

Recent use

Any designer drug

Chest pain

Cardiac ischemia, myocarditis

Bath salts, synthetic cannabinoids

Renal

Acute kidney injury

Recent use

Synthetic cannabinoids

Gastrointestinal

Nausea, vomiting

Recent use or withdrawal syndrome

Synthetic cannabinoids

Enlarged and/or tender liver

Acute hepatitis

Any injected designer drug

Musculoskeletal

Muscle spasms

Intoxication

Bath salts

Limb swelling and pain

Rhabdomyolysis

Bath salts, synthetic hallucinogens

Skin

Diaphoresis

Recent use

Bath salts

Ecchymosis

Recent use or intoxication

Synthetic hallucinogens

Fresh needle marks, track marks

Injection drug use

Any injected designer drug

Neurologic

Clonus

Recent use

Synthetic hallucinogens

Seizures

Intoxication

Bath salts, synthetic hallucinogens, synthetic cannabinoids

Psychiatric

Agitation

Recent use

Any designer drug

Hallucinations

Recent use

Any designer drug

Psychosis

Intoxication

Any designer drug