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Dextromethorphan overdose

Definition

This is poisoning from swallowing a large amount of dextromethorphan, a medicine that helps stop coughs (cough suppressant).

Alternative Names

DXM overdose; Robo overdose; Orange crush overdose; Red devils overdose;Triple C's overdose

Poisonous Ingredient

• Dextromethorphan

Where Found

Dextromethorphan is found in many over-the-counter cough and cold medicines, including:

• Robitussin DM
• Triaminic DM
• Rondec DM
• Benylin DM
• Drixoral
• St. Joseph Cough Suppressant
• Coricidin
• Alka-Seltzer Plus Cold and Cough
• NyQuil
• DayQuil
• TheraFlu
• Tylenol Cold
• Dimetapp DM

The drug is also abused and sold on the streets under the names:

• Orange crush
• Triple C's
• Red Devils
• Skittles
• Dex

Note: This list may not be all inclusive.

Symptoms

• Heart and blood vessels
  • Low blood pressure
• Lungs
  • Breathing - slow and labored
  • Breathing - shallow
  • No breathing
• Eyes, ears, nose, and throat
  • Blurred vision
• Skin
  • Bluish colored fingernails and lips
• Gastrointestinal
  • Spasms of the stomach and intestines
  • Nausea
  • Vomiting
  • Constipation
• Heart and blood
  • Rapid heart beat
  • High blood pressure
• Nervous system
  • Drowsiness
  • Dizziness
  • Hallucinations
  • Muscle spasticity (twitches)
  • Coma

Home Treatment

This can be a serious overdose. Seek immediate medical help.

Before Calling Emergency

Determine the following information:

• Patient's age, weight, and condition
• Name of product (as well as the ingredients and strength, if known)
• Time it was swallowed
• Amount swallowed
• If the medicine was prescribed for the patient

Poison Control, or a local emergency number

The National Poison Control Center (1-800-222-1222) can be called from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the U.S. use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

Take the container with you to the hospital, if possible.

See National Poison Control center.

What to expect at the emergency room

The health care provider will measure and monitor the patient's vital signs, including temperature, pulse, breathing rate, and blood pressure. The patient may receive:

• Medicines to treat symptoms
• Medicines to make the person throw up
• Activated charcoal
• Laxative
• A nasogastric (NG) tube thru the nose into the stomach to empty the stomach (gastric lavage)
• A narcotic antagonist (medicine to reverse the effect of the painkiller)

Expectations (prognosis)

If medicine to reverse the effects of the overdose are given, recovery may occur within 1 to 4 hours.

According to the FDA, at least five reported deaths of teenagers may be linked to dextromethorphan abuse. 

References

U.S. Food and Drug Administration. FDA Warns Against Abuse of Dextromethorphan (DXM). Rockville, MD: National Press Office; May 20, 2005. Talk Paper T05-23.

Review Date:4/4/2006
Reviewed By:Janeen R. Azare, PhD, MSPH, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY. Review provided by VeriMed Healthcare Network.

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