Synthetic cathinone toxicity - Revision history

Rossdonaldson1 at 06:20, 27 November 2021

2021-11-27T06:20:39Z

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	#Baumann MH, Partilla JS, Lehner KR. Psychoactive "bath salts": not so soothing. Eur J Pharmacol. 2013 Jan 5;698(1-3):1-5. doi: 10.1016/j.ejphar.2012.11.020. Epub 2012 Nov 23. PMID: 23178799; PMCID: PMC3537229.		#Baumann MH, Partilla JS, Lehner KR. Psychoactive "bath salts": not so soothing. Eur J Pharmacol. 2013 Jan 5;698(1-3):1-5. doi: 10.1016/j.ejphar.2012.11.020. Epub 2012 Nov 23. PMID: 23178799; PMCID: PMC3537229.
	#O’Connor AD, Padilla-Jones A, Gerkin RD, Levine M. Prevalence of rhabdomyolysis in sympathomimetic toxicity: a comparison of stimulants. J Med Toxicol 2015 Jun;11(2):195-200.		#O’Connor AD, Padilla-Jones A, Gerkin RD, Levine M. Prevalence of rhabdomyolysis in sympathomimetic toxicity: a comparison of stimulants. J Med Toxicol 2015 Jun;11(2):195-200.

			[[Category:Toxicology]]

2021-01-13T18:22:06Z

Differential Diagnosis

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	==Differential Diagnosis==		==Differential Diagnosis==
	*Sympathomimetic toxicity		==Differential Diagnosis==
	**~~Methamphetamines~~		*[[Sympathomimetic toxicity]]
	**~~Cocaine~~		**Red, dry skin and absent bowel sounds favors anticholinergic toxicity
	*Anticholinergic ~~toxicity~~		*[[Encephalitis]]
			*[[Head trauma]]
			*ETOH/sedative withdrawal
			*[[Neuroleptic Malignant Syndrome (NMS)]]
			*Acute psychotic disorder

			{{Toxidrome Chart}}

			{{AMS and fever DDX}}

			{{Anticholinergic Toxicity Treatement}}

	==Evaluation==		==Evaluation==

2021-01-13T18:17:56Z

Background

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	*Sharp increase in exposures around 2007-2011 due to products sold as “bath salts” and labelled “not for human consumption”		*Sharp increase in exposures around 2007-2011 due to products sold as “bath salts” and labelled “not for human consumption”
	*Common synthetic versions found today include mephedrone, methylone, MDPV, and many others		*Common synthetic versions found today include mephedrone, methylone, MDPV, and many others
	Bupropion is only cathinone derivative used medically in the US and Europe		*[[Bupropion]] is only cathinone derivative used medically in the US and Europe

	===Mechanism of Action===		===Mechanism of Action===

2020-11-26T22:05:49Z

Clinical Features

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	==Clinical Features==		==Clinical Features==
	[[File:Qat man.jpg\|thumb\|Man chewing khat (Yemen).]]		[[File:Qat man.jpg\|thumb\|Man chewing khat (Yemen).]]
	*Presents similar to other sympathomimetics		*Presents similar to other [[sympathomimetics]]
	*Patient experiences euphoria, increased energy, agitation, psychosis, hallucinations		*Patient experiences euphoria, increased energy, agitation, [[psychosis]], [[hallucinations]]
	*Case reports suggest tachycardia tends to be more severe than hypertension (HR >150 and SBP<150)		*Case reports suggest tachycardia tends to be more severe than hypertension (HR >150 and SBP<150)
	*Can lead to psychosis, agitated delirium, seizures, hyperthermia, rhabdo, cardiovascular collapse, renal failure, hepatic dysfunction, DIC and death		*Can lead to psychosis, agitated delirium, [[seizures]], [[hyperthermia]], [[rhabdo]], cardiovascular collapse, [[renal failure]], hepatic dysfunction, [[DIC]] and [[death]]
	**Retrospective review showed OR of 3.09 and 7.98 for rhabdomyolysis and severe rhabdomyolysis compared to other sympathomimetics		**Retrospective review showed OR of 3.09 and 7.98 for rhabdomyolysis and severe rhabdomyolysis compared to other sympathomimetics

2020-11-26T22:05:14Z

Clinical Features

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	==Clinical Features==		==Clinical Features==
			[[File:Qat man.jpg\|thumb\|Man chewing khat (Yemen).]]
	*Presents similar to other sympathomimetics		*Presents similar to other sympathomimetics
	*Patient experiences euphoria, increased energy, agitation, psychosis, hallucinations		*Patient experiences euphoria, increased energy, agitation, psychosis, hallucinations

2020-11-26T22:02:19Z

Differential Diagnosis

2020-11-26T22:02:02Z

Differential Diagnosis

2020-11-26T21:59:43Z

Background

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	**Release of neurotransmitters from intracellular stores		**Release of neurotransmitters from intracellular stores
	*Beta-ketone group decreases ability to penetrate BBB		*Beta-ketone group decreases ability to penetrate BBB

			{{Sympathomimetic types}}

	==Clinical Features==		==Clinical Features==

2020-11-26T21:57:34Z

Management

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	==Management==		==Management==
	*In general, care is supportive		*In general, care is supportive
	*IVF for dehydration/[[rhabdo]]/AKI		*[[IVF]] for dehydration/[[rhabdo]]/[[AKI]]
	*[[Benzodiazepines]] for agitation		*[[Benzodiazepines]] for agitation

2020-11-26T21:56:58Z

Management

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	==Management==		==Management==
	*In general, care is supportive		*In general, care is supportive
	*IVF for dehydration/rhabdo/AKI		*IVF for dehydration/[[rhabdo]]/AKI
	*Benzodiazepines for agitation		*[[Benzodiazepines]] for agitation

	==Disposition==		==Disposition==