Monotti R
Medizinische Universitätsklinik, Inselspital Bern.
Schweiz Med Wochenschr. 1993 May 1;123(17):881-6.
Opiate intoxication accounts for the majority of emergencies related to substance abuse. The concomitant intravenous and intramuscular administration of the specific narcotic antagonist naloxone is warranted in such cases. Further threatening complications of opiate abuse include rhabdomyolysis, noncardiogenic pulmonary edema, and both peripheral and central nervous lesions. Opiate abuse is often associated with benzodiazepine abuse. Hence, intravenous administration of the antagonist flumazenil is indicated in patients with suspected acute opiate intoxication resistant to naloxone. Cocaine abuse is not frequent in this country but is usually very severe and clinically heterogeneous. The clinical pattern of cocaine intoxication is initially due to excitatory and later to depressant effects on central nervous, circulatory and respiratory systems. The treatment of acute cocaine intoxication is symptomatic. The internal concealment of cocaine and other drugs in packets (body-packing) may lead to bowel obstruction or to acute intoxication following leaking or breaking of packets.
阿片类药物中毒是药物滥用相关急诊的主要原因。在此类情况下，有必要同时静脉内和肌肉内注射特定的阿片类拮抗剂纳洛酮。阿片类药物滥用的其他严重并发症包括横纹肌溶解、非心源性肺水肿以及外周和中枢神经损伤。阿片类药物滥用常与苯二氮䓬类药物滥用相关。因此，对于疑似急性阿片类药物中毒且对纳洛酮耐药的患者，需静脉注射拮抗剂氟马西尼。可卡因滥用在该国并不常见，但通常非常严重且临床表现多样。可卡因中毒的临床症状最初是由于对中枢神经、循环和呼吸系统的兴奋作用，随后是抑制作用。急性可卡因中毒的治疗以对症治疗为主。将可卡因和其他药物藏于体内包裹中（人体藏毒）可能会导致肠梗阻，或因包裹泄漏或破裂而导致急性中毒。
