Hermanns-Clausen Maren, Kithinji Josephine, Spehl Marco, Angerer Verena, Franz Florian, Eyer Florian, Auwärter Volker
Poisons Information Center, Center for Pediatrics and Adolescent Medicine, Medical Center - University of Freiburg, Freiburg, Germany.
Institute of Forensic Medicine, Forensic Toxicology, Medical Center - University of Freiburg, Germany.
Drug Test Anal. 2016 Oct;8(10):1030-1038. doi: 10.1002/dta.1936. Epub 2016 Jan 15.
Since 2009, more than 140 different synthetic cannabinoids (SC) have been identified in herbal mixtures consumed as recreational drugs. Knowledge of the acute toxicity of each individual compound remains sparse. Here we present a retrospective observational case series of patients presenting to emergency departments with analytically confirmed intake of JWH-210 as the only SC detected in serum samples. Cases were selected from a poison centre database from March 2011 to June 2014. In total, 22 patients were included (aged 12-25 years, median 17.5; 18 males 4 female). JWH-210 was identified in the serum samples in concentrations ranging from 0.18 to 90 ng/mL. Tachycardia, nausea, somnolence, hypokalemia, hypertension, restlessness, and/or agitation were most frequently reported. Diplopia, seizures, syncope, and ECG changes such as T-wave inversion and bradycardia were also noted. Acute adverse effects of JWH-210 typically include central nervous system depression or cerebral seizures, but also signs of sympathomimetic toxicity. Nausea was reported in 80% and typically shows a sudden onset shortly after inhalation, suggesting a central nervous effect possibly mediated by CB receptors. Cardiovascular effects are reported in up to 80% of the patients and might not only include alterations in blood pressure and heart rate, but also changes in the electrocardiogram (ECG). JWH-210 as a representative of a strong CB receptor agonist confirms previous reports about adverse effects of SC, but shows a distinct quantitative pattern of symptoms, compared to several other SC. Copyright © 2016 John Wiley & Sons, Ltd.
自2009年以来，在作为消遣性毒品使用的草药混合物中已鉴定出140多种不同的合成大麻素（SC）。关于每种化合物急性毒性的了解仍然很少。在此，我们呈现一个回顾性观察病例系列，这些患者因血清样本中经分析确认仅检测到JWH - 210而被送往急诊科。病例选自2011年3月至2014年6月的一个毒物中心数据库。总共纳入了22例患者（年龄12 - 25岁，中位数17.5岁；18例男性，4例女性）。血清样本中鉴定出的JWH - 210浓度范围为0.18至90 ng/mL。最常报告的症状有心动过速、恶心、嗜睡、低钾血症、高血压、烦躁不安和/或激动。还注意到复视、癫痫发作、晕厥以及心电图变化，如T波倒置和心动过缓。JWH - 210的急性不良反应通常包括中枢神经系统抑制或脑部癫痫发作，也有拟交感神经毒性的迹象。80%的患者报告有恶心，通常在吸入后不久突然发作，提示可能由CB受体介导的中枢神经效应。高达80%的患者报告有心血管效应，这可能不仅包括血压和心率的改变，还包括心电图变化。JWH - 210作为一种强效CB受体激动剂的代表，证实了先前关于合成大麻素不良反应的报道，但与其他几种合成大麻素相比，显示出独特的症状定量模式。版权所有© 2016约翰威立父子有限公司。
