Unintentional cannabis poisoning in toddlers: A one year study in Marseille

Mehamha, Hilel; Doudka, Natalia; Minodier, Philippe; Néant, Nadège; Lacarelle, Bruno; Solas, Caroline; Fabresse, Nicolas

doi:10.1016/j.forsciint.2021.110858

Cited by 6 publications

(9 citation statements)

References 19 publications

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“…As mentioned earlier, legal and societal background determines the likelihood that anesthesiologists will encounter individuals consuming cannabinoids for various reasons [12,28,37,38,64]. However, the increased prevalence of cannabinoid compounds is such that accidental intake has been reported in all ages, including newborns [65][66][67][68]. Intake of cannabinoids from FDA-approved medication remains a minuscule proportion of cannabis intake by the general population [47][48][49][50].…”

Section: Utilization Of Cannabinoidsmentioning

confidence: 99%

“…This is further complicated by the inability of current testing to recognize acute vs. delayed/chronic cannabinoid intake, as the metabolites measured in urine have a long half-life [180]. Finally, exposure to cannabinoids may occur in an insidious/second-hand way, impacting the ability to consent [66,68,230,346]. On the practical level, assessing an individual's ability to render an informed decision should be undertaken and documented in the chart following standard practices.…”

Section: Preoperative Periodmentioning

confidence: 99%

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Considerations for Cannabinoids in Perioperative Care by Anesthesiologists

Laudański

Wain

2022

JCM

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Increased usage of recreational and medically indicated cannabinoid compounds has been an undeniable reality for anesthesiologists in recent years. These compounds’ complicated pharmacology, composition, and biological effects result in challenging issues for anesthesiologists during different phases of perioperative care. Here, we review the existing formulation of cannabinoids and their biological activity to put them into the context of the anesthesia plan execution. Perioperative considerations should include a way to gauge the patient’s intake of cannabinoids, the ability to gain consent properly, and vigilance to the increased risk of pulmonary and airway problems. Intraoperative management in individuals with cannabinoid use is complicated by the effects cannabinoids have on general anesthetics and depth of anesthesia monitoring while simultaneously increasing the potential occurrence of intraoperative hemodynamic instability. Postoperative planning should involve higher vigilance to the risk of postoperative strokes and acute coronary syndromes. However, most of the data are not up to date, rending definite conclusions on the importance of perioperative cannabinoid intake on anesthesia management difficult.

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Section: Utilization Of Cannabinoidsmentioning

confidence: 99%

Section: Preoperative Periodmentioning

confidence: 99%

Considerations for Cannabinoids in Perioperative Care by Anesthesiologists

Laudański

Wain

2022

JCM

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“…There is a great difference in the patterns, rate, frequency and different substances which are used as poisons in different countries and in different regions of large countries [4–6,7 ▪ ]. Various factors are at play including but not limited to religion, economic status, and cultural connotations.…”

Section: Introductionmentioning

confidence: 99%

Metabolic management of accidental intoxication

Khatib,

Dixit,

Telang

2024

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

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Purpose of review Unintentional intoxication comprises a major chunk of all intoxications. Most patients are in the pediatric age group with another set of patients being the elderly. Substances found to cause accidental intoxication vary from country to country and even within different regions of a country. Frequent reviews of current literature are needed to be abreast of trends. Recent findings Prescription drugs and household chemicals are major culprits when it comes to accidental intoxication. Acetaminophen, digoxin and metformin are some of the prominent prescription drugs frequently associated with unintentional intoxications. Increasingly alcohol based hand sanitizers are becoming an important etiology of these events, following their increased usage during the COVID-19 pandemic. Pattern recognition to identify class of intoxicant and supportive care including prevention of further absorption and increased excretion are cornerstones of therapy. Antidote when available should be used promptly. Summary Knowledge about current epidemiology of accidental intoxications, toxidrome pattern recognition and appropriate antidote usage beside adequate and timely supportive care help in successful management of the unfortunate victim of accidental intoxication.

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“…2,3 After THC ingestion, THC-COOH takes 1 to 3 hours to peak in serum and may persist in urine for multiple days in naive users 4 ; thus, premature or delayed urine samples from large acute exposures may also be in that range. While children symptomatic from acute exposures generally have urinary THC-COOH of 15 ng/mL or greater, 5,6 some do not, particularly young children. 6 Study limitations were the single center in a state with legalized cannabis, restricting generalizability, and the hospital's UDS threshold of 25 ng/mL (often, 50 ng/mL) THC-COOH.…”

mentioning

confidence: 99%

“…While children symptomatic from acute exposures generally have urinary THC-COOH of 15 ng/mL or greater, 5,6 some do not, particularly young children. 6 Study limitations were the single center in a state with legalized cannabis, restricting generalizability, and the hospital's UDS threshold of 25 ng/mL (often, 50 ng/mL) THC-COOH. However, a 50 ng/mL UDS threshold may miss additional pediatric THC exposures.…”

mentioning

confidence: 99%