A university student is brought to the emergency department after having a seizure at a party. The heart rate is 110 beats per minute, the respiratory rate is 18 breaths per minute, and the blood pressure is 160/95 mm Hg
The patient is agitated and restless and has tremors. The patient takes clonidine for ADHD. The nurse smells alcohol on the patient's breath. Toxicology results are pending. The nurse suspects what about this patient?
a. The patient has severe alcohol poisoning.
b. An adverse drug interaction between the clonidine and the alcohol has occurred.
c. The patient may have consumed a large amount of caffeine.
d. The patient may have ingested strychnine.
ANS: C
In large doses, caffeine produces nervousness and tremors; in very large doses, it can cause convulsions. People often consume caffeine when drinking alcohol to offset the sedative effects of the alcohol, and many college students consume highly caffeinated energy drinks with alcohol. Severe alcohol poisoning may produce seizures, but the patient would not be agitated and restless. Clonidine would cause somnolence, which would increase with alcohol. Strychnine causes severe muscle stiffness.
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