Dobaja Mojca, Grenc Damjan, Kozelj Gordana, Brvar Miran
a Centre for Clinical Toxicology and Pharmacology, Division of Internal Medicine , University Medical Centre Ljubljana , Ljubljana , Slovenia.
b Institute of Forensic Medicine, Faculty of Medicine , University of Ljubljana , Ljubljana , Slovenia.
Clin Toxicol (Phila). 2017 Mar;55(3):193-195. doi: 10.1080/15563650.2016.1278224. Epub 2017 Jan 13.
Synthetic cannabinoids are getting more popular among young people and illicit manufacturers. We report a case series of occupational transdermal poisoning with synthetic cannabinoids.
Three customs inspectors got in contact with a sticky substance with their fingertips because they were not wearing protection gloves and the delivered package was damaged. Despite washing their hands with water, signs of synthetic cannabinoids intoxication started occurring half an hour after exposure. On arrival at the Emergency Department six hours later, they were somnolent, lethargic and confused. They showed signs of mydriasis, blurred vision, ataxia, weakness, numbness, tachycardia and one of them had orthostatic hypotension. Two days later, they were feeling much better and reported amnesia and slowed perception of time after exposure. Toxicology analysis by LC-MS/MS revealed synthetic cannabinoid cumyl-PINACA (SGT-24) in their blood samples taken on admission. cumyl-PINACA was also confirmed with NMR method in liquid samples seized at the airport. It was 98% pure substance with the purpose of being diluted and sold further in the drug market by drug dealer.
This case series highlights the possible transdermal exposure to synthetic cannabinoids oil resulting in prolonged cannabinoid syndrome.
合成大麻素在年轻人和非法制造商中越来越受欢迎。我们报告了一系列合成大麻素经皮中毒的病例。
三名海关检查员因未戴防护手套且所运送的包裹破损，手指接触到了一种粘性物质。尽管用水洗手，但接触半小时后仍开始出现合成大麻素中毒迹象。六小时后到达急诊科时，他们嗜睡、无精打采且意识模糊。他们表现出瞳孔散大、视力模糊、共济失调、虚弱、麻木、心动过速的症状，其中一人有体位性低血压。两天后，他们感觉好多了，并报告接触后出现失忆和时间感知减慢的情况。入院时采集的血液样本经液相色谱 - 串联质谱法（LC-MS/MS）毒理学分析显示，他们的血液中含有合成大麻素戊基 - PINACA（SGT-24）。在机场查获的液体样本中，通过核磁共振（NMR）方法也证实了戊基 - PINACA的存在。它是纯度为98%的纯物质，目的是由毒贩进一步稀释并在毒品市场销售。
该病例系列突出了经皮接触合成大麻素油可能导致长期大麻素综合征。
