A woman brings her teenage daughter into the emergency department. The teen is lethargic, dizzy, and has been vomiting. While the teen is being examined and stabilized, the mother tells the nurse that her daughter told her that she and her friends used to get high. The mother states, 1-“ could Cough Syrup do this?” 2- is the nurse’s B

response.

1. Cough syrup can indeed cause the symptoms described by the teenage girl. Cough syrup contains an active ingredient called dextromethorphan (DXM), which is a commonly abused substance by adolescents seeking a recreational high. When taken in large amounts, DXM can result in a condition known as “robotripping.” Robotripping refers to the use of high doses of cough syrup to achieve a dissociative state, similar to the effects of ketamine or PCP.

The symptoms of robotripping can include lethargy, dizziness, and vomiting, as seen in the teenage girl. Additionally, some individuals may experience hallucinations, confusion, impaired motor coordination, and even seizures. The severity of symptoms can vary depending on the amount of cough syrup consumed and the individual’s tolerance.

It is essential for healthcare professionals to consider the possibility of substance abuse, particularly in adolescents presenting with unusual symptoms. While cough syrup abuse may seem unlikely or unfamiliar to some healthcare providers, it is critical to ask appropriate questions and gather a comprehensive history from both the patient and their guardian.

2. The nurse’s response should be professional and empathetic. It is important for the nurse to establish a supportive and non-judgmental environment to facilitate open communication with both the teenage girl and her mother. The nurse should acknowledge the mother’s concerns and assure her that they will assess and treat her daughter appropriately.

The nurse may respond by saying, “Thank you for sharing this information with me. It is possible that the symptoms your daughter is experiencing could be related to cough syrup abuse. Abuse of cough syrup, particularly those containing dextromethorphan, can lead to various side effects, including the symptoms you mentioned. We will thoroughly evaluate your daughter and provide the necessary medical care.”

Following this response, the nurse should continue with the assessment of the teenage girl, focusing on both the presenting symptoms and potential substance abuse-related issues. This may involve ordering laboratory tests, such as urine toxicology screening, to confirm the presence of substances in the patient’s system.

Additionally, the nurse should also consider the emotional and psychological well-being of the teenage girl. Substance abuse in adolescence can often be indicative of underlying social or emotional issues. Therefore, the nurse should be prepared to provide appropriate referrals for counseling or substance abuse treatment services as necessary.

In summary, cough syrup abuse, particularly in the form of high doses of dextromethorphan, can cause symptoms such as lethargy, dizziness, and vomiting. It is crucial for healthcare professionals to consider substance abuse when presented with these symptoms, particularly in adolescent patients. Nurses should respond professionally, showing empathy and understanding, and proceed with a comprehensive assessment and treatment plan for both the physical and psychological well-being of the patient.