Synthetic cannabinoids: Difference between revisions
| Line 10: | Line 10: | ||
*Typical onset of 10-30 min and taper over 1-2 hours | *Typical onset of 10-30 min and taper over 1-2 hours | ||
*'''Tachycardia and hypertension''' common (distinguishing it from MJ use) | *'''Tachycardia and hypertension''' common (distinguishing it from MJ use) | ||
*Adverse effects:;nausea, vomiting, diaphoresis, anxiety, paranoia, hallucinations, agitation, | *Adverse effects:;nausea, vomiting, diaphoresis, anxiety, paranoia, hallucinations, agitation, delirium | ||
*Use has been associated with AKI and acute cerebral ischemia.<ref>Buser GL, Gerona RR, Horowitz BZ, et al. Acute kidney injury associated with smoking synthetic cannabinoid. Clin Toxicol (Phila). 2014;52(7):664–73.</ref><ref>Takematsu M, Hoffman RS, Nelson LS, Schechter JM, Moran JH, Wiener SW. A case of acute cerebral ischemia following inhalation of a synthetic cannabinoid. Clin Toxicol (Phila). 2014;52(9):973–5.</ref> | *Use has been associated with AKI and acute cerebral ischemia.<ref>Buser GL, Gerona RR, Horowitz BZ, et al. Acute kidney injury associated with smoking synthetic cannabinoid. Clin Toxicol (Phila). 2014;52(7):664–73.</ref><ref>Takematsu M, Hoffman RS, Nelson LS, Schechter JM, Moran JH, Wiener SW. A case of acute cerebral ischemia following inhalation of a synthetic cannabinoid. Clin Toxicol (Phila). 2014;52(9):973–5.</ref> | ||
Revision as of 16:19, 26 March 2018
Background
- Common street names: spice, K2, Moon Rocks, Blue Lotus, many others
- Active ingredients frequently change to avoid legal proscription
- Generally contains cannabinoid receptor agonists (CB1 or CB2) that are far more potent than THC
- Does not show up on routine tox screen
- Generally smoked, but can be imbibed as a tea
Clinical Features
- Similar effect to marijuana at low doses, but may be more intense and cause an acute Excited delirium
- Typical onset of 10-30 min and taper over 1-2 hours
- Tachycardia and hypertension common (distinguishing it from MJ use)
- Adverse effects:;nausea, vomiting, diaphoresis, anxiety, paranoia, hallucinations, agitation, delirium
- Use has been associated with AKI and acute cerebral ischemia.[1][2]
Differential Diagnosis
Sympathomimetics
- Cocaine
- Amphetamines
- Synthetic cathinones (khat)
- Ketamine
- Ecstasy (MDMA)
- Synthetic cannabinoids
- Bath salts
Drugs of abuse
- 25C-NBOMe
- Alcohol
- Amphetamines
- Bath salts
- Cocaine
- Ecstasy
- Gamma hydroxybutyrate (GHB)
- Heroin
- Inhalant abuse
- Hydrocarbon toxicity
- Difluoroethane (electronics duster)
- Marijuana
- Kratom
- Phencyclidine (PCP)
- Psilocybin ("magic mushrooms")
- Synthetic cannabinoids
- Chloral hydrate
- Body packing
Evaluation
- Clinical diagnosis
Management
- Supportive care
- May require sedative agent such as benzodiazepines or antipsychotics, as well as physical restraints, if severely agitated and posing a threat to self and staff
Disposition
- Generally may be discharged once sober (assuming no adverse effects that would mandate admission)
See Also
References
- ↑ Buser GL, Gerona RR, Horowitz BZ, et al. Acute kidney injury associated with smoking synthetic cannabinoid. Clin Toxicol (Phila). 2014;52(7):664–73.
- ↑ Takematsu M, Hoffman RS, Nelson LS, Schechter JM, Moran JH, Wiener SW. A case of acute cerebral ischemia following inhalation of a synthetic cannabinoid. Clin Toxicol (Phila). 2014;52(9):973–5.