Synthetic Cannabinoid ‘Bonzai’ Intoxication: Six Case Series

Ergül, Dursun Fırat; Ekemen, Serdar; Yelken, Birgül

doi:10.5152/tjar.2015.05668

Cited by 16 publications

(17 citation statements)

References 9 publications

(10 reference statements)

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“…Our study reports confusion and tachycardia as the most frequent symptoms. Several studies showed that SCs use leads to increased creatinine kinase, lactic dehydrogenase, hyperglycemia, hypokalemia and acidosis, (17,18) which is similar to our study.…”

Section: Discussionsupporting

confidence: 91%

“…The most common presenting symptoms among patients on admission were unstable cognitive conditions (drowsiness, clouding of consciousness, confusion and secondary aggression, anxiety and restlessness) and tachycardia. Only one patient had The mean duration of the observation was 11.5(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21) hours. No mortality was observed.…”

mentioning

confidence: 99%

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Identification of Substance Abuse Among Children in a Pediatric Emergency Department

Çiftdemir¹,

Eren²,

Karal³

2020

jpr

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Illicit substance use is a worldwide important public health problem with increasing substance abuse rates and decreasing starting age. In this study, our aim was to determine the complaints of the patients in pediatric emergency department (PED) admission in order to increase awareness about substance abuse. Materials and Methods: The data of this cross-sectional study was gathered from those patients admitted to a PED with complaints of substance abuse and patients without a history of substance abuse, but with a positive urine drug test. A screening urine test was used for the qualitative determination of drug substances. If positive, a quantitative liquid chromatography integrated mass/mass spectrometry test was ordered for confirmation. Results: A total of 17 patients presented to the emergency department. The most frequent symptoms were unstable cognitive conditions and tachycardia. Laboratory analyses showed high creatine kinase-MB. Synthetic cannabinoids were the most frequently detected substance in urine screening and confirmation tests. Twenty-nine percent of patients were hospitalized and no mortality was observed. Conclusion: The use of illegal substances has increased in teenagers. Emergency department doctors must be informed and trained regarding substance abuse since patients frequently presented to the emergency department with cognitive malfunctions. Also, it should be remembered that patients may present with symptoms concerning various organ systems.

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Section: Discussionsupporting

confidence: 91%

mentioning

confidence: 99%

Identification of Substance Abuse Among Children in a Pediatric Emergency Department

Çiftdemir¹,

Eren²,

Karal³

2020

jpr

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“…Beside the effects on the central nervous system (agitation, confusion, hallucinations, tremor, convulsions, muscle spasms, paranoia, psychosis a.k.a. "spiceophrenia", somnolence, and suicidal thoughts and actions), they are associated with cardiovascular effects (tachycardia, hypertension, chest pain, and dyspnoea), nausea, vomiting, hypokalaemia, high creatine phosphokinase, and more recently with cerebrovascular infarction, acute renal failure, and acute myocardial infarction in previously healthy young people, including fatalities (5)(6)(7)(8)(9)(10)(11)(12)(13).…”

Section: Methodsmentioning

confidence: 99%

“…The bulk powder is then dissolved in acetone and methanol, sprayed onto a plant material (usually Damiana and Lamiaceae herbs), dried, and packed (5). The products analysed in this study usually contained herbs such as Mentha and Thymus, sprayed with a SCRA mixture (11,12).…”

mentioning

confidence: 99%

Clinical and analytical experience of the National Poison Control Centre with synthetic cannabinoids

Vučinić

Kilibarda

Đorđević

et al. 2018

Archives of Industrial Hygiene and Toxicology

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A rising number of patients are being treated for overdosing with new psychoactive substances (NPS) available at the illegal drug market in Serbia. The aim of this study was to report clinical and analytical experience of the National Poison Control Centre of Serbia (NPCC) with synthetic cannabinoids (SCs) and point to the NPS available at the illegal drug market in our country. From January 2013 to December 2016, 58 patients (aged between 14 and 25) were treated for the effects of synthetic cannabinoids at the NPCC. Tachycardia was established in 53, mydriasis in 31, somnolence, nausea, vomiting, and agitation in 16, dizziness in 10, disorientation in 9, dyspnoea and chest pain in 4, and loss of consciousness, pallor, paraesthesia, muscle twitches, and short-term memory impairment in 2 patients. After receiving symptomatic and supportive treatment in the emergency ward, all patients had fully recovered within 8 h and were discharged shortly afterwards. Another part of the study was focused on the analysis of the products known under their local street names as "Biljni tamjan" (herbal incense), "Beli slez", and "Rainbow Special" and the analysis of urine sampled from the patients with gas chromatography - mass spectrometry and high performance liquid chromatography. The detected synthetic cannabinoids were AB-PINACA, JWH-018, JWH-122, JWH-210, 5F-AKB48, and MDMB-CHMICA in herbal products and AB-FUBINACA, AB-CHMINACA, and MDMB-CHMICA in the urine samples. Our findings have shown the great capacity of NPCC to I) monitor NPS abuse in Serbia, II) reliably detect SCs in illicit products and biological samples, and III) clinically manage the adverse effects in their users. Future commitments of the NPCC will include systematic collection of relevant data on SCs and their adverse effects, detection of changes in purity and composition of the controlled NPS-based products, and raising the public awareness of NPS to improve the effectiveness of the national Early Warning System.

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“…The first explanation that comes to mind is a picture that develops due to substance intoxication. Elevations in CK, CK_MB, and AST parameters due to SC intoxication were previously reported in case reports [14, 15]. However, a systematic review on 3965 cases reported rhabdomyolysis in only 0.1% and delirium in 0.2% of SCs toxication cases [16].…”

Section: Discussionmentioning

confidence: 91%

Delirium and High Creatine Kinase and Myoglobin Levels Related to Synthetic Cannabinoid Withdrawal

Yazıcı

Erol

2017

Case Reports in Medicine

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Synthetic cannabinoids (SCs) are included in a group of drugs called new psychoactive substances. Effects of SCs on the central nervous system are similar to other cannabinoids, but 2–100 times more potent than marijuana. Thus, addiction and withdrawal symptoms are more severe than natural cannabinoids. Withdrawal symptoms of SCs were reported in the literature previously. But there is no report about SC withdrawal delirium and its treatment. Several studies reported that agonists of CB1 receptors play a role in GABA and glutamatergic neurotransmission, which is similar to the effects of alcohol on GABA and glutamatergic receptors. Previous studies on alcohol delirium cases suggested that elevated creatine kinase (CK) can be a marker of progress. This study reports delirium and high serum CK levels related to SC withdrawal and offers a treatment with benzodiazepine for them. We described two cases treated in our inpatient clinic about SC withdrawal with increase of serum CK level and other laboratory parameters. One of them demonstrated delirium symptoms and the other did not with early rapid treatment.

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Synthetic Cannabinoid ‘Bonzai’ Intoxication: Six Case Series

Cited by 16 publications

References 9 publications

Identification of Substance Abuse Among Children in a Pediatric Emergency Department

Identification of Substance Abuse Among Children in a Pediatric Emergency Department

Clinical and analytical experience of the National Poison Control Centre with synthetic cannabinoids

Delirium and High Creatine Kinase and Myoglobin Levels Related to Synthetic Cannabinoid Withdrawal

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