Death by acute multiple drug injestion

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Hi. I am a new nursing student and have a question. It deals with physiology.

When someone has trouble breathing, has seizures and then goes into cardiac arrest from acute multiple drug injestion (heroin, cocaine, valium, etc.) what physically happens to the body?? Is the nervous system just overloaded and can't regulate processes because of the upper and downer effects of all the drugs?? What causes this type of reaction?

I know this a pretty in-depth question and I have searched around on the Internet with phrases to try and find some info. on it to no avail. Can any of you seasoned folks explain why a client may present these physiological manifestations?

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Specializes in Flight, ER, Transport, ICU/Critical Care.

Stimulant Drugs - cocaine, crystal meth, crack - all increase HR, BP, MVO2. So these folks have arrhythmias, BP increases until a vessel pops in the head or they have some type of coronary artery occlusion/spasm (AMI)

Opiates - heroin, oxycontin, fentanyl, morphine - generally kill by profound RESPIRATORY depression. RR goes down, LOC decreases and the patient can NOT protect their airway. In my experience many aspirate and that contributes to cause of death.

Benzos - valium, ativan, xanax - as far as I know there has NEVER been a documented case of death due to BENZO ingestion alone. But, I imagine if you take enough of anything - there has to be a lethal dose. Since you asked about "multiple drug ingestion", this class of drug is easily obtained/mixed with ETOH and would contribute to markedly altered LOC with subsequent failure of the patient to protect their own airway. These drugs are widely used.

We don't see too much PCP anymore - thankfully. Many of those died as a result of negative acceleration - i.e. They thought they could fly off of buildings, outrun trains, etc.

But one of the worst overdoses I've seen involved TCA's (lots of cardiac involvement) and the Anticholinergic SX - Hot as a Hare, Red as a Beet, Dry as a Bone, Strong as an Ox, Blind as a Bat, Mad as a Hatter, etc - syndromes. Bad - hard to treat.

The other really bad OD's I've witnessed:

* involved a 15 yo that took her grandpa's extended release iron tablets -

* benadryl/tylenol (100 PM tabs) yep that is 2.5 GRAMS Benadryl and 50 GRAMS of TYLENOL - plus the rhabdo CK 50,000+ from lying in a ditch for 12 hours with self inflicted knife wounds

* ASA overdose is brutal too.

Now as to what kills folks that mix it up? Pick anything - but, I'd bet the patient has altered LOC & fails to maintain an airway as the leading cause of death. I'd guess rhythm disturbance to be next. After that end organ failure due to ingestion quantity.

.

:o

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also, risk of renal and liver failure from being overworked to rid body of drugs

my sig other recently made a suicide attempt (battling with severe clinical depression... but that's a whole other story - he's doing much better now) and the ER nurse said that a tylenol overdose is about the worst way to go

for those that are interested, it was an od of effexor and lunesta... the lunesta depressed his respiration and lowered pulse ox and was put on a respirator to protect airway and O2 to help w/ oxygen levels, and the effexor stood the chance of causing arrythmias (which never occured, thank god)... he did aspirate, which eventually gave him a slight case of pnuemonia. i also learned that aterial blood draws are incredibly painful to the patient.

as a side note, i thought he had about the best nursing care while he was in the er and ccu... it made me that much more excited to become a nurse.

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Wow. Thanks NREMT. I am just a beginning RN student, but I figured that it was brian and heart related since the person injested both uppers and downers. The body probably just could not figure out what to do and just overloaded and the person seized and died. THANK YOU for the in-depth explanation. I was actually talking about the late River Phoenix. I was a fan of his and around the same age as him when he died many years ago of muliplte drug injestion. The medical report said there were numerous drugs in his system both uppers and downers. Supposedly he was in the club, got shakey, had trouble breathing, passed out then came to, and when they got him outside he seized and then went into cardiac arrest. He was dead a short time later. Anyway, I was just wondering the physiology behind the reaction that killed him. Thank you for taking the time to explain.

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Specializes in Neuro ICU, Neuro/Trauma stepdown.

Which is exactly what happened to anna nicole smith, which included being malnourished and with out of whack electrolytes from the weight gain/loss, exhaustion from grief over the death of her son and of course, being septic from all those dirty injections in her buttocks....what a shame

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