Phencyclidine

Aka: Phencyclidine, PCP

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II. Background

  1. Class
    1. Dissociative Agent and Hallucinogen
    2. Schedule II
  2. Street Names
    1. Angel dust
    2. Hog
    3. Horse Tranquilizer

III. Pharmacokinetics

  1. PCP (2-10 mg): 3-18 hour duration

IV. Signs

  1. Low dose
    1. Intoxication
    2. Nystagmus
  2. Moderate dose
    1. Hypersalivation
    2. Fever
    3. Repetitive movements
    4. Muscle rigidity
  3. High dose
    1. Psychosis
    2. Violent Behavior
    3. Hypertension
    4. Tachycardia
  4. Very high dose
    1. Coma
    2. Seizure
    3. Rhabdomyolysis

V. Labs

  1. Evaluate Renal Function and Creatine Kinase for Rhabdomyolysis in severe Intoxication

VI. Differential Diagnosis

  1. See Hallucinogen
  2. Dextromethorphan Toxicity may have similar effect (and a False Positive urine tox for PCP)

VII. Management: Toxicity

  1. See Toxin Ingestion
  2. Supportive care
  3. Consider Restraints for Violent Behavior
    1. Physical Restraints (with one-to-one monitoring)
    2. Chemical Restraints
  4. Benzodiazepines
  5. External cooling
  6. Status Epilepticus management (if Seizures occur)
  7. Dantrolene (Muscle Relaxant) Indications
    1. Severe hyperthermia
    2. Rhabdomyolysis

VIII. References

  1. Tagliaferro (2023) Crit Dec Emerg Med 37(1): 21-9

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