title: Case Series of Synthetic Cannabinoid Intoxication from One Toxicology Center.
abstract: Synthetic cannabinoid use has risen at alarming rates. This case series describes 11 patients exposed to the synthetic cannabinoid, MAB-CHMINACA who presented to an emergency department with life-threatening toxicity including obtundation, severe agitation, seizures and death. All patients required sedatives for agitation, nine required endotracheal intubation, three experienced seizures, and one developed hyperthermia. One developed anoxic brain injury, rhabdomyolysis and died. A significant number were pediatric patients. The mainstay of treatment was aggressive sedation and respiratory support. Synthetic cannabinoids pose a major public health risk. Emergency physicians must be aware of their clinical presentation, diagnosis and treatment.
authors.affiliation: Department of Emergency Medicine, Lehigh Valley Health Network, Allentown, Pennsylvania.
authors.forename: Kenneth D
authors.initials: KD
authors.lastname: Katz
authors.affiliation: Department of Emergency Medicine, Lehigh Valley Health Network, Allentown, Pennsylvania.
authors.forename: Adam L
authors.initials: AL
authors.lastname: Leonetti
authors.affiliation: Department of Emergency Medicine, Lehigh Valley Health Network, Allentown, Pennsylvania.
authors.forename: Blake C
authors.initials: BC
authors.lastname: Bailey
authors.affiliation: Department of Emergency Medicine, Lehigh Valley Health Network, Allentown, Pennsylvania.
authors.forename: Ryan M
authors.initials: RM
authors.lastname: Surmaitis
authors.affiliation: Department of Emergency Medicine, Lehigh Valley Health Network, Allentown, Pennsylvania.
authors.forename: Eric R
authors.initials: ER
authors.lastname: Eustice
authors.affiliation: NMS Labs, Willow Grove, Pennsylvania.
authors.forename: Sherri
authors.initials: S
authors.lastname: Kacinko
authors.affiliation: Pediatric Critical Care, Lehigh Valley Health Network, Allentown, Pennsylvania.
authors.forename: Scott M
authors.initials: SM
authors.lastname: Wheatley
mesh_terms: D000293:Adolescent; D000328:Adult; D063386:Cannabinoid Receptor Agonists / Q000506:poisoning; D002186:Cannabinoids / Q000506:poisoning*; D005260:Female; D005334:Fever / Q000139:chemically induced* / Q000628:therapy; D006801:Humans; D013287:Illicit Drugs / Q000506:poisoning*; D007191:Indazoles / Q000506:poisoning*; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D019064:Product Packaging; D011634:Public Health; D012640:Seizures / Q000139:chemically induced* / Q000628:therapy; D019966:Substance-Related Disorders; D055815:Young Adult
chemical_list: D063386:Cannabinoid Receptor Agonists; D002186:Cannabinoids; D013287:Illicit Drugs; D007191:Indazoles; C000614303:MAB-CHMINACA