Patients should not be allowed to become acidotic because acidosis causes increased amounts of salicylates to enter cell membranes. Full investigation of electrolytes, blood sugar, salicylate concentrations, blood gases and prothrombin time should be done at regular intervals. Aquamephyton 10 mg subcutaneously should be given. The use of the tricyclic antidepressants is common by those involved with drugs of abuse. A cardiac monitor should be used to detect cardiac arrhythmias and these would require treatment according to the evidence of cardiotoxicity.
Many drugs used recreationally can produce psychosis when taken in high doses.
Any user showing psychosis requires a detailed assessment. Precipitating factors of drug psychosis type of drug hallucinogens, eg LSD, magic mushrooms psychostimulants cannabis solvents drug use in non-supportive environments Perpetuating factors which may lead to drug psychosis further drug use in hospital, eg drugs provided by visitors concurrent drug withdrawal. There is a medical emergency which requires detailed assessment. Danger to oneself and others needs to be determined. The more disorganised and bizarre the person is, the greater the risk.