Altintop Ismail, Karakukcu Cigdem
Department of Emergency Medicine, Health Science University Kayseri Training and Research Hospital, Kayseri 38010, Turkey.
Department of Biochemistry, Health Science University Kayseri Training and Research Hospital, Kayseri 38010, Turkey.
Behav Sci (Basel). 2018 Sep 22;8(10):88. doi: 10.3390/bs8100088.
The chameleon can disguise itself in nature by taking on different colors and forms. As synthetic cannabinoids (SC) have clinically similar effects to those of several psychoactive agents, they are one of the most difficult intoxications to diagnose. The reasons for this are due to clinical variations throughout the world and the differences in symptoms having not been determined due to their similarity to the intoxication of several other drugs. The aim of this study was to obtain prospective data of patients presenting at the Emergency Department (ED) with suspected SC intoxication, and as a result of prospective examination of samples, to determine a new generation of SC use, SC types, clinical findings, and treatments. A total of a 15 patients with suspected SC intoxication who presented at the ED of the Health Sciences University Kayseri Training and Research Hospital between January 2017 and January 2018 were examined. Samples taken prospectively from patients who were followed-up for a diagnosis of SC intoxication were examined with the HR LC-MS/MS method; SC were determined, and the test results of other psychoactive agents that were used concurrently were examined. Three significant findings emerged as a result of this study. Firstly, due to the different clinical forms of presentation at ED associated with SC use and the range of intoxications that cannot be diagnosed, advanced laboratory tests are required, in addition to routine tests for the determination of SC. Secondly, those diagnosed as having taken SC were also determined to have used it concurrently with substances that have a high potential for addiction, such as amphetamines and quetiapine. Thirdly, in regard to examples of cases presented in the literature, anti-psychotics, fluid hydration, and anxiolytics can be used as treatment options for those diagnosed with SC use.
变色龙能够通过呈现不同的颜色和形态在自然界中伪装自己。由于合成大麻素（SC）在临床上与几种精神活性药物具有相似的效果，它们是最难诊断的中毒类型之一。造成这种情况的原因在于世界各地临床情况的差异，以及由于其与其他几种药物中毒症状相似，症状差异尚未确定。本研究的目的是获取急诊科疑似SC中毒患者的前瞻性数据，并通过对样本的前瞻性检查，确定新一代SC的使用情况、SC类型、临床发现和治疗方法。对2017年1月至2018年1月期间在开塞利培训与研究医院健康科学大学急诊科就诊的15例疑似SC中毒患者进行了检查。对为诊断SC中毒而进行随访的患者前瞻性采集的样本采用HR LC-MS/MS方法进行检测；确定了SC，并检查了同时使用的其他精神活性药物的检测结果。本研究得出了三个重要发现。首先，由于与SC使用相关的急诊科不同临床表现形式以及无法诊断的中毒范围，除了用于确定SC的常规检测外，还需要先进的实验室检测。其次，被诊断服用SC的患者还被确定同时使用了具有高成瘾潜力的物质，如苯丙胺和喹硫平。第三，关于文献中呈现的病例实例，抗精神病药物、补液和抗焦虑药物可作为诊断为使用SC患者的治疗选择。
