A 27-Year-Old Man Exits a Bar's Men's Room After Smoking

A 27-year-old man exits a bar's men's room after smoking an unknown drug. He quickly gets disoriented and aggressive. The man makes jerky, uncontrolled movements with his limbs and strikes a bouncer who attempts to calm him down. When police and emergency medical workers come, he fights off four cops before being subdued, and he seems painless. The patient suffers visual hallucinations at the emergency room, is unable to comply with the questioning, and swings between agitation and drowsiness. He is hypertensive and tachycardic, with vertical nystagmus on examination. The patient refuses to participate in urine toxicology tests. Several hours later, when questioned by the emergency physician, he cannot recall the majority of the preceding events. Which of the following is the primary mechanism of action of the drug most likely used by this patient?

A) Dopamine receptor antagonism
B) GABA-A receptor modulation
C) Mu-opioid receptor agonism
D) N-methyl-D-aspartate receptor antagonism
E) Serotonin receptor agonism

Correct Answer:

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