It has now been at least 6 hours since his intake. Both forms are stable when smoked and highly bioavailable. Pharmacokinetics are similar to injected cocaine via this route. Cocaine blocks this pump's function, thereby preventing re-uptake of bioactive amines. Consequently, epinephrine, norepinephrine, serotonin and dopamine persist in the presynpase causing prolonged and exaggerated effects.
Beta stimulation leads to tachycardia, sweating, mydriasis, and tremor.
Alpha receptor stimulation causes mostly vasospasm which results in hypertension and ischemia. Dopaminergic effects are additive to these symptoms and additionally alter mood and movement. Lastly, serotonin effects may contribute to an actual serotonin syndrome of hallucinations, hyperthermia and exhilaration. Interestingly, it may be the sodium channel blockade in the brain which causes seizures and coma. Your nurse argues that the patient's pain began hours after inhalation and moreover it is pleuritic.