Obafemi Adebisi I, Kleinschmidt Kurt, Goto Collin, Fout Drew
UT Southwestern Medical Center, Dallas, TX, USA.
Texas Department of Public Safety, Garland, TX, USA.
J Med Toxicol. 2015 Dec;11(4):426-9. doi: 10.1007/s13181-015-0482-z.
Synthetic cannabinoid receptor agonists (SCRAs) are emerging designer drugs of abuse. Most reports on the health effects of these drugs are case reports. Unlike SCRAs, marijuana has classically been used via many routes of exposure including oral, such as in brownies. We report on 11 symptomatic patients who unknowingly ingested brownies laced with analytically confirmed SCRA and presented with mostly neuropsychiatric and cardiovascular symptoms.
All 11 patients were taken to the ED within 1 h of exposure with the onset of various symptoms. There were five males and six females, age range 20-57 years. Neuropsychiatric and cardiovascular symptoms predominated: memory impairment (91 %, 10/11) and inappropriate giggling (36 %, 4/11). All the patients had light-headedness, perioral and facial numbness and tingling sensation, dry mouth, difficulty focusing/blurring of vision, and sluggishness. No patient had depressed consciousness. Two patients had heart rates >100, and 4 of 11 (36 %) had BP >140/80. One patient had chest pain. All the symptoms were completely resolved 4 h following their onset except two patients who had ongoing weakness and fatigue. All patients had negative urine drugs of abuse immunoassays and ethanol, acetaminophen, and salicylate concentrations, as well as normal electrocardiograms (ECGS) and metabolic panels. The SCRA was confirmed to be AM-2201. All the patients were discharged from the ED in stable condition within 10 h of the exposure.
Oral exposure of 11 patients to brownies laced with analytically confirmed SCRA resulted in neuropsychiatric and cardiovascular symptoms. This series reflects that like marijuana, oral exposures to SCRAs can lead to symptoms.
合成大麻素受体激动剂（SCRAs）是新出现的滥用设计药物。关于这些药物对健康影响的大多数报告都是病例报告。与SCRAs不同，大麻传统上有多种给药途径，包括口服，比如做成布朗尼蛋糕。我们报告了11例有症状的患者，他们在不知情的情况下食用了经分析确认含有SCRAs的布朗尼蛋糕，主要表现为神经精神和心血管症状。
所有11例患者在接触后1小时内因出现各种症状被送往急诊科。其中男性5例，女性6例，年龄在20至57岁之间。以神经精神和心血管症状为主：记忆障碍（91%，10/11）和不适当的傻笑（36%，4/11）。所有患者均有头晕、口周和面部麻木及刺痛感、口干、注意力不集中/视力模糊和反应迟钝。没有患者意识不清。2例患者心率>100，11例中有4例（36%）血压>140/80。1例患者有胸痛。所有症状在出现后4小时完全缓解，除了2例患者仍有持续的虚弱和疲劳。所有患者的尿液滥用药物免疫分析、乙醇、对乙酰氨基酚和水杨酸盐浓度均为阴性，心电图（ECG）和代谢指标也正常。经确认，该SCRAs为AM - 2201。所有患者在接触后10小时内从急诊科出院，病情稳定。
11例患者口服含有经分析确认的SCRAs的布朗尼蛋糕后出现神经精神和心血管症状。该系列病例表明，与大麻一样，口服SCRAs也会引发症状。
