Phencyclidine (Sernylan) poisoning

Case 1. A 3-year-old white boy presented to the emergency ward approximately two hours after ingesting three tablets described by his parents as "tranquilizers." The patient became quite lethargic 1 89 hours after ingestion and then rapidly progressed to an unresponsive state. On admission he was comatose with persistent opisthotonic posturing. Respirations were slow and shallow with intermittent gasps. Pupils were miotic in midposition with alternating vertical and horizontal nystagmus. Deep tendon reflexes were depressed. Shortly after admission the patient had a respiratory arrest but responded to assisted ventilation, Elective intubation was performed, the stomach was lavaged, and supportive therapy instituted. Four hours after ingestion respirations became regular. At eight hours, the opisthotonic posturing