Match each clinical presentation of acute substance intoxication to the primary molecular mechanism of the offending agent.
- Euphoria, mydriasis, and ischemic chest pain in a young adult.Inhibition of presynaptic monoamine reuptake transporters
- Severe tooth decay, skin excoriations, and prolonged psychosis.Displacement of monoamines from presynaptic vesicles
- Visual hallucinations, synesthesia, and intact reality testing.Partial agonism at the serotonin 5-HT2A receptor
- Extreme psychomotor agitation, multidirectional nystagmus, and reduced pain perception.Non-competitive antagonism at the NMDA glutamate receptor
- Acute severe psychosis, tachycardia, and seizures after smoking an unregulated 'herbal' mixture.Full agonism at the CB1 and CB2 endocannabinoid receptors
Answer
Cocaine to reuptake inhibition; Methamphetamine to vesicular displacement; LSD to 5-HT2A agonism; PCP to NMDA antagonism; Synthetic cannabinoids to CB1/CB2 full agonism.
Each clinical presentation perfectly matches the unique mechanism of action of the offending drug. Recognizing the specific toxidrome allows for the identification of the substance and its corresponding molecular mechanism.
Step-by-Step Solution
Key Concept
Substance Intoxication Toxidromes and Molecular Mechanisms