Intracerebral hemorrhage with multiple intracranial arterial stenoses in a synthetic cannabinoid “Spice” user

Aydın, Seçkin; Yuksel, Odhan; Aydın, Ayşegül Esen; Kızılkılıç, Osman; Çelik, Suat Erol

doi:10.4103/ajns.ajns_48_16

Cited by 7 publications

(2 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Aside from the recent outbreak of severe bleeding occurring mostly in Illinois and also in other states, reports on coagulopathies as adverse effects have been limited. Other reports of bleeding have included the development of a right frontal intracerebral hematoma in a habitual user of spice 28. In addition, published reports28,29 have demonstrated instances of intracranial hemorrhage following use of spice.…”

Section: Resultsmentioning

confidence: 99%

Review of the many faces of synthetic cannabinoid toxicities

Alipour¹,

Patel

Shabbir

et al. 2019

Mental Health Clinician

View full text Add to dashboard Cite

Introduction Synthetic cannabinoids (SCs) are psychoactive substances that are gaining popularity for their availability and lack of detection by standardized drug tests. Although some users may perceive SCs as safer alternatives to marijuana, some SCs are more potent and result in more severe toxicities. Methods A search of the literature was conducted in the PubMed and SciFinder databases. Results in PubMed were limited to human studies, and only articles in English were included. Results Review of the literature illustrates the hazards associated with SC use. A range of severe toxicities affecting numerous systems has been identified, such as arrhythmias, myocardial infarction, sudden cardiac death, psychosis, suicidal ideation, seizures, acute tubular necrosis, and intracranial hemorrhage. Additionally, a recent outbreak of coagulopathies and at least 4 associated deaths due to SCs tainted with brodifacoum have been reported. Discussion Synthetic cannabinoids may be perceived as a safer alternative to marijuana; however, SCs can be more potent at the cannabinoid receptors and in turn have greater toxicities. Limited information is available on the metabolism of SCs; however, cytochrome P450 pathways may be involved, which could result in drug interactions and unpredicted adverse effects. Toxicity with SC use is not just related to its effects, but also to additives that may taint these products and enhance their effects. Health care providers should be aware of the range of toxicities related to SC use, and tainted products such as these agents are not detected on routine drug screens.

show abstract

Section: Resultsmentioning

confidence: 99%

Review of the many faces of synthetic cannabinoid toxicities

Alipour¹,

Patel

Shabbir

et al. 2019

Mental Health Clinician

View full text Add to dashboard Cite

show abstract

“…Several case reports have described the occurrence of intracranial bleeding following SC use. In one case, a 23-year-old male suffered intracerebral hemorrhage (ICH) that was speculated to be due to the induction of multiple intracranial arterial stenosis (MIAS) that deteriorated to ICH [ 9 ]. Other cases include a Japanese patient with intracranial bleeding who had a history of arteriovenous malformation [ 10 ], and three reports of patients with subarachnoid hemorrhage (SAH) [ 11 , 12 ].…”

Section: Should Cytochrome P450 Inducers Be Used To Increase Long-actmentioning

confidence: 99%

Should Cytochrome P450 Inducers be Used to Accelerate Clearance of Brodifacoum from Poisoned Patients?

et al. 2019

View full text Add to dashboard Cite

A recent multi-state outbreak of life-threatening bleeding following inhalation of synthetic cannabinoids has been attributed to contamination with the long-acting anticoagulant rodenticide (LAAR) brodifacoum, a second-generation, highly potent, long-acting derivative of the commonly used blood thinner warfarin. While long-term treatment with high-dose vitamin K1 restores coagulation, it does not affect brodifacoum metabolism or clearance, and, consequently, brodifacoum remains in the human body for several months, thereby predisposing to risk of bleeding recurrence and development of coagulation-independent injury in extrahepatic tissues and fetuses. This has prompted the evaluation of pharmacological measures that accelerate brodifacoum clearance from poisoned patients. Since the induction of certain cytochrome P450 (CYP) enzymes accelerates warfarin metabolism, using CYP inducers, such as phenobarbital, to accelerate brodifacoum clearance seems plausible. However, unlike warfarin, brodifacoum does not undergo significant metabolism in the liver, nor have the effects of phenobarbital on vitamin K1 metabolism been previously determined. In addition, the safety of phenobarbital in brodifacoum-poisoned patients has not been established. Therefore, we propose that CYP inducers should not be used to accelerate the clearance of brodifacoum from poisoned patients, but that alternative approaches such as reducing enterohepatic recirculation of brodifacoum, or using lipid emulsions to scavenge brodifacoum throughout the body, be considered.

show abstract

Basic Substance Characteristics and Neuropathological Findings in Drug Abusers

Büttner

2020

Neuropathology of Drug Abuse

View full text Add to dashboard Cite

Intracerebral hemorrhage with multiple intracranial arterial stenoses in a synthetic cannabinoid “Spice” user

Cited by 7 publications

References 19 publications

Review of the many faces of synthetic cannabinoid toxicities

Review of the many faces of synthetic cannabinoid toxicities

Should Cytochrome P450 Inducers be Used to Accelerate Clearance of Brodifacoum from Poisoned Patients?

Basic Substance Characteristics and Neuropathological Findings in Drug Abusers

Contact Info

Product

Resources

About