title: The New Designer Drug Wave: A Clinical, Toxicological, and Legal Analysis.
abstract: This article reviews clinical, toxicological, and legal issues related to designer drug abuse, with a focus on synthetic cathinones (bath salts). Synthetic cathinones are amphetamine-type central nervous system (CNS) stimulants that produce similar effects to amphetamine. Like amphetamine, synthetic cathinones can also result in neurological and cardiovascular side-effects consistent with sympathomimetic toxicity. The differential for a patient presenting with the signs and symptoms of synthetic cathinone toxicity is broad, and laboratory testing for synthetic cathinones is of limited value in acute management. If a diagnosis of cathinone-induced delirium is suspected, treatment efforts should focus on controlling agitation and then treating medical complications such as metabolic acidosis. Physicians should be aware of these new drugs, not only to optimally treat patients, but also to raise awareness of the dangers of designer drug use through patient counseling and community outreach programs.
authors.affiliation: a Adjunct Assistant Professor, David Geffen School of Medicine at University of California, Los Angeles, CA and Associate Professor , Southwestern Law School , Los Angeles , CA.
authors.forename: Ryan
authors.initials: R
authors.lastname: Abbott
authors.affiliation: b Principal, David E. Smith, MD & Associates , San Francisco , CA.
authors.forename: David E
authors.initials: DE
authors.lastname: Smith
mesh_terms: D000470:Alkaloids / Q000009:adverse effects* / Q000138:chemical synthesis; D000662:Amphetamines / Q000009:adverse effects; D000697:Central Nervous System Stimulants / Q000009:adverse effects*; D003693:Delirium / Q000139:chemically induced; D015198:Designer Drugs / Q000009:adverse effects*; D006801:Humans; D007880:Legislation, Drug
chemical_list: D000470:Alkaloids; D000662:Amphetamines; D000697:Central Nervous System Stimulants; D015198:Designer Drugs; C023665:cathinone
keywords: amphetamine; bath salts; psychoactive; stimulants; toxicity