Baum Regan A, Bailey Abby, Chan Ryan, Blumenschein Karen
1 University of Kentucky HealthCare, Department of Pharmacy Services, Lexington, KY, USA.
2 University of Kentucky College of Pharmacy, Department of Pharmacy Practice and Science, Lexington, KY, USA.
J Pharm Pract. 2018 Apr;31(2):238-243. doi: 10.1177/0897190017699761. Epub 2017 Mar 30.
The purpose of this work was to retrospectively review patient cases presenting to the University of Kentucky Chandler Medical Center (UKCMC) emergency department (ED) with symptoms of suspected synthetic cannabinomimetic (SC) intoxication. These drugs, currently undetected by standard urine drug screen tests, comprise a structurally diverse group of compounds designed to mimic the psychoactive effects of Δ-tetrahydrocannabinol (Δ-THC), the primary psychoactive cannabinoid in marijuana.
Fourteen cases of suspected SC intoxication were identified between July 1, 2015, through September 30, 2015. The median patient age was 25.5 years (range: 13-45 years), and most (64%) patients were males. The most common psychoactive symptom was agitation (n = 6, 42.9%), while the most common physical symptoms were altered level of consciousness (n = 9, 64.3%) and mydriasis (n = 3, 21.4%). Most cases resolved without complication in 24 hours; 2 patients required hospitalization.
Recent legislation has failed to curb the public health concerns emanating from SC misuse. Education about the risks of SC use along with additional regulation may be required to remove the false sense of safety that some individuals, especially adolescents and young adults, may associate with these compounds, which are often misconstrued as "herbal marijuana." Clinicians need to be prepared to identify and treat symptoms of SC intoxication as incidents of toxicity continue to rise.
本研究旨在回顾性分析肯塔基大学钱德勒医学中心（UKCMC）急诊科收治的疑似合成大麻素类似物（SC）中毒患者的病例。这些药物目前无法通过标准尿液药物筛查检测出来，它们是一组结构多样的化合物，旨在模拟Δ-四氢大麻酚（Δ-THC）的精神活性作用，Δ-THC是大麻中主要的精神活性大麻素。
在2015年7月1日至2015年9月30日期间，共识别出14例疑似SC中毒病例。患者的年龄中位数为25.5岁（范围：13 - 45岁），大多数（64%）患者为男性。最常见的精神活性症状是烦躁不安（n = 6，42.9%），而最常见的身体症状是意识水平改变（n = 9，64.3%）和瞳孔散大（n = 3，21.4%）。大多数病例在24小时内无并发症地康复；2名患者需要住院治疗。
近期的立法未能遏制因滥用SC而引发的公共卫生问题。可能需要开展关于使用SC风险的教育并加强监管，以消除一些人，尤其是青少年和年轻人，可能与这些化合物相关联的错误安全感，这些化合物常被误解为“草药大麻”。随着中毒事件持续增加，临床医生需要做好识别和治疗SC中毒症状的准备。
