View source for Bath salts toxicity

==Background==
[[File:RadoxBathSalts.jpg|thumb|Bath salts]]
*Found in herbal products sold under guise of "not for human consumption"
**May be found under brand name Aura, Ivory wave, Vanilla sky
*Active ingredients vary; often contain methylenedioxyprovalerone (MDPV) or mephedrone
*Similar effects to [[Ecstasy (MDMA)]], [[cocaine]], [[methamphetamines]]

==Clinical Features==
*[[Sympathomimetic toxicity|Sympathomimetic toxidrome]]
**Tachycardia
**Hypertension
**Agitation
**Paranoia
**Hyperthermia
*[[Hallucinations]]
*Psychomotor agitation

==Differential Diagnosis==
{{Sympathomimetic types}}
{{Drugs of abuse types}}

==Evaluation==
===Work-Up===
*Fingerstick glucose
*Complete metabolic panel
*Coags
*CK
*Urine tox screen not helpful, usually negative

===Diagnosis===
*Diagnosis is based on history and physical exam

==Management==
*[[Benzodiazepines]] for agitation
*Rapid cooling for hyperthermia
*Paralyze if hyperthermia uncontrolled (avoid [[Succinylcholine]] due to hyperkalemia)
*IV hydration
*Monitor urine output

===Contra-indicated===
*Do not use butyrophenones (e.g. [[Haldol]]) or second gen antipsychotic (e.g. [[Geodon]]) as first line agents
**They interfere with heat dissipation, lower seizure threshold, may prolong QTc

==Disposition==
===Admission===
*Admit for lab abnormalities or persistent [[Altered Mental Status (AMS)|AMS]]
===Discharge===
*Discharge after observation period if [[Altered Mental Status (AMS)|AMS]] and [[Sympathomimetic toxicity|sympathomimetic]] symptoms resolve with out end-organ damage
*MDPV has an estimated 6-8 hour duration of action, but may vary. Consider consult with poison control prior to discharge.

==Complications==
*[[Rhabdomyolysis]]
*[[Cardiomyopathy]]
*[[Valvular heart disease]]
*Cardiac arrhythmias
*[[Pulmonary hypertension]]
*[[Aortic dissection]]
*Acute tubular necrosis

==See Also==
*[[Sympathomimetic toxicity]]
*[[Altered Mental Status (AMS)]]

==External Links==
*[http://www.emdocs.net/bath-salts/ emDocs - Bath Salts]

==References==
<references/>

[[Category:Toxicology]]