Division of Medical Toxicology, Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Center for Forensic Science Research & Education, Fredric Rieders Family Foundation, Willow Grove, PA, USA.
Clin Toxicol (Phila). 2022 Apr;60(4):524-526. doi: 10.1080/15563650.2021.1975734. Epub 2021 Sep 9.
Synthetic cannabinoids (SCs) are a structurally heterogenous synthetic class of drugs of abuse. The objective was to describe the incidence of acute respiratory failure in Emergency Department (ED) patients with confirmed SC exposure, and to investigate the association between SC overdose with respiratory failure compared to non-SC overdose.
This was an observational cohort of ED patients ≥18 years with suspected cannabinoid overdose between 2015 and 2020 at two tertiary-care hospitals. Patient serum was analyzed liquid chromatography/quadrupole time-of-flight mass spectrometry using a library with >800 drugs including novel psychoactive substances. The primary outcome was acute respiratory failure.
Of 83 patients with suspected cannabinoid overdose, there were 29 confirmed SC overdoses: 5 F-MDMB-PICA ( = 18) and its metabolite 5OH-MDMB-PICA ( = 16), ADB-FUBINACA ( = 4), AB-CHIMINACA ( = 4), AB-FUBINACA ( = 1), AB-PINACA ( = 1), MDMB-4en-PINACA ( = 1), and 4 F-MDMB-BINACA ( = 1). Overall, incidence of acute respiratory failure was 31.3% (95%CI 21.6-42.4). Compared to non-SC overdose, confirmed SC overdose was significantly associated with respiratory failure (25.0% SC vs. 4.2% non-SC, = 0.05).
This study demonstrates that SCs are associated with respiratory failure. Since respiratory depression is a potentially lethal adverse effect of SC overdose, future research is warranted.
合成大麻素（SCs）是一种结构多样的滥用药物。本研究旨在描述急诊科（ED）中确认的 SC 暴露患者急性呼吸衰竭的发生率，并探讨与非-SC 过量相比，SC 过量与呼吸衰竭之间的关联。
这是一项在 2015 年至 2020 年间在两家三级保健医院对疑似大麻素过量的≥18 岁 ED 患者进行的观察性队列研究。使用包含 >800 种药物（包括新型精神活性物质）的库，通过液相色谱/四极杆飞行时间质谱法对患者血清进行分析。主要结局为急性呼吸衰竭。
在 83 例疑似大麻素过量的患者中，有 29 例确诊为 SC 过量：5-氟甲二氧基苯丙胺（5-FMDMB-PICA，18 例）及其代谢物 5-羟基-5-甲氧基二苯并吡嗪（5OH-MDMB-PICA，16 例）、ADB-FUBINACA（4 例）、AB-CHMINACA（4 例）、AB-FUBINACA（1 例）、AB-PINACA（1 例）、MDMB-4en-PINACA（1 例）和 4-氟甲二氧基苯丙胺（4-FMDMB-BINACA，1 例）。总体而言，急性呼吸衰竭的发生率为 31.3%（95%CI 21.6-42.4）。与非-SC 过量相比，确认的 SC 过量与呼吸衰竭显著相关（25.0%的 SC 与 4.2%的非-SC， = 0.05）。
本研究表明 SC 与呼吸衰竭有关。由于呼吸抑制是 SC 过量的潜在致命不良反应，因此需要进一步研究。
