Cocaine use disorder Quiz: Ace Your Exams

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A 35-year-old man is brought to the emergency department by EMS after he was found at a public park yelling at bystanders. Several unlabeled pill capsules are found in his belongings. Temperature is 100°F (37.7 °C), pulse is 117 bpm, respiratory rate is 18 breaths per minute, and blood pressure is 177/90 mmHg. The patient appears agitated and diaphoretic. On physical examination, the patient has noted mydriasis bilaterally. There is absence of clonus in the lower extremities bilaterally. Oral mucosa appears moist. Intranasal examination reveals septal ulceration. Which of the following is the most likely etiology of this patient’s clinical presentation? 

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