bugs crawling on skin

[shigella123]

On FA it says it's seen in Cocaine and in one of the question it was not cocaine, but in methamphetamine.
Is it seen in many of the substance abuse or in both of these or only in amphetamine? Any help?

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[NeuroLAX]

Formication and delusional parasitosis are seen in multiple conditions, substance abuse being one of them. Cocaine and methamphetamine are common culprits. Were they both answer choices?

 

[shigella123]

The question gave me description of a pt experiencing symptoms of dilated pupils, diaphoresis, agitated, being resistant, and says feels ants crawling and was inhaling "something on aluminum foil". I remembered it from FA it was specified for cocaine so I was thinking of that and not meth.

 

[Donald Juan]

People inhale meth off aluminum foil. Don't ask me how you're supposed to know that based on med school knowledge.

 

[penguinism]

I think you can also see formication in delirium tremens! (but this question sounds more like drug abuse)

 

[shigella123]

It's so hard for me to get these type of question right. They all have almost the same presentation and I was going to rely on "ants crawling on skin" to know it's cocaine abuse since it's mentioned in FA.

 

[CherryRedDracul]

You don't smoke pure coke HCl; you cook it into crack or freebase it first.

People inhale meth off aluminum foil. Don't ask me how you're supposed to know that based on med school knowledge.

Crack or freebase can also be smoked off foil. I haven't read the question, but it looks like OP would have had to base his answer off knowing that cocaine typically isn't readily combustible in its HCl form and/or meth has a much longer half-life compared to coke.

EDIT: Took a look at the question just now. The presentation is classic for someone high on stimulants. None of the other answer choices would make sense. If they had both meth and coke as answer choices, I would be calling foul.

 

[shigella123]

I think I know now what I was doing wrong. So, almost all stimulants can have same presentation of "bug crawling".

Thanks guys

 

[ninjasurgeron]

Dilated pupils + sweating would have pointed towards stimulants.

 

[Handinhand]

Just a heads up shigella so you don't knee-jerk answer as stimulant use -- formication (or the feeling of ant crawling on your skin) is also common in alcohol withdrawal, so it's very important to read the symptom list to determine whether they're high from a stimulant or haven't had a drink in a day.

 

[shigella123]

Dilated pupils + sweating would have pointed towards stimulants.

FA says, sweating is seen in depressants not stimulants.

 

[shigella123]

Just making sure, if I see formication next time on a question then I should think of alcohol withdraw, cocaine, and amphetamines anything else?

 

[Delacroix22]

People inhale meth off aluminum foil. Don't ask me how you're supposed to know that based on med school knowledge.

People also "smoke" (inhaling a vaporized form) of Oxycontin off aluminum foil as well.

Not that that adds anything to the conversation, but thought I should mention