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https://www.readbyqxmd.com/read/28325154/the-behavioral-profile-of-methylenedioxypyrovalerone-mdpv-and-%C3%AE-pyrrolidinopentiophenone-pvp-a-systematic-review
#1
Cornel N Stanciu, Thomas M Penders, Samantha A Gnanasegaram, Elvin Pirapakaran, Juvraj S Padda, Jeeven S Padda
BACKGROUND: New psychoactive substances are emerging at an alarming rate. With novel structures and properties they produce unique behavioral characteristics during intoxication. Synthetic cathinones are some of the most common. More and more are presenting to emergency departments due to consequences of use. Aside from isolated reports, little is known about these compounds. OBJECTIVE: Here we review literature pertaining to two common synthetic cathinones, MDPV and alphaPVP, and correlate clinically with guidance on management of intoxications...
March 21, 2017: Current Drug Abuse Reviews
https://www.readbyqxmd.com/read/28246413/dexmedetomidine-to-control-signs-associated-with-lisdexamfetamine-dimesylate-toxidrome-in-a-cat
#2
Christopher L Norkus, Iain Keir, Charlotte Means
A 5-month-old intact female domestic shorthaired cat had mydriasis, agitation, and increased locomotion after ingestion of lisdexamfetamine, 10.3 mg/kg body weight (BW). Despite treatment with IV fluids, IV acepromazine, oral cyproheptadine and intravenous lipid emulsion the patient's clinical signs worsened. Dexmedetomidine administered at 2 μg/kg BW and continued at 0.5 μg/kg BW per hour rapidly controlled the patient's signs. An episode of vomiting and hematuria developed. Follow-up 5 days after discharge revealed that the cat appeared normal...
March 2017: Canadian Veterinary Journal. la Revue Vétérinaire Canadienne
https://www.readbyqxmd.com/read/28238395/profound-hypotension-and-bradycardia-in-the-setting-of-synthetic-cannabinoid-intoxication-a-case-series
#3
David O Andonian, Shauna R Seaman, Elaine B Josephson
Cannabinoids are the most commonly used illegal substances in the world [1]. Synthetic Cannabinoids (SCB) are also known as "Spice", "K2", "Spike", "herbal incense", "Cloud 9", "Mojo" and many others are becoming a large public health concern due to their increasing use, unpredictable toxicity, and abuse potential [2]. The most common reported toxicities with SCB use based on studies using Texas Poison control record are tachycardia, agitation and irritability, drowsiness, hallucinations, delusions, hypertension, nausea, confusion, dizziness, vertigo, chest pain, acute kidney injury, seizures, heart attacks and both ischemic and hemorrhagic strokes [3]...
January 12, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28238224/a-comparative-toxidrome-analysis-of-human-organophosphate-and-nerve-agent-poisonings-using-social-media
#4
D S Reddy, E Colman
Here we utilized social media to compare the toxidrome of three lethal chemical exposures worldwide. YouTube videos were the main source from which the data were collected, but published reports and news were also utilized to fill in some gaps. All videos were organized in a database detailing symptoms and severity of each victim, along with demographics such as approximate age and gender. Each symptom was rated as mild, moderate, or severe and corresponding pie graphs for each incident were compared. The videos displayed symptoms ranging from mild to severe cholinergic toxicity and life-threatening convulsions...
February 26, 2017: Clinical and Translational Science
https://www.readbyqxmd.com/read/28217606/a-mixed-toxidrome-presenting-with-bilateral-ptosis-with-normal-pupils-the-first-case-in-the-literature
#5
Sanket Mahajan, Janki Shah
Snakebite is an environmental hazard associated with a significant morbidity and mortality. Two main types of toxicity occur due to snakebite, namely vasculotoxicity and neurotoxicity. Neurotoxic snakebites present mainly with bilateral ptosis with dilated pupils and/or difficulty in breathing. Jatropha curcas belongs to the family Euphorbiaceae and is commonly referred to as "Ratanjyot" in Gujarati. It has got many medicinal uses such as anticancerous properties and bio-oil. There are very few cases of its toxicity in adults...
July 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/28035035/analysis-of-u-47700-a-novel-synthetic-opioid-in-human-urine-by-lc-ms-ms-and-lc-qtof
#6
Steven W Fleming, Justin C Cooley, Leonard Johnson, C Clinton Frazee, Kristina Domanski, Kurt Kleinschmidt, Uttam Garg
The illicit drug market has rapidly evolved from synthetic cannabinoids to cathinone derivatives and now a new emerging threat of synthetic opioids. These compounds were mostly developed by pharmaceutical companies during drug discovery. The new psychoactive substances are not routinely covered in drug screening and may go undetected. Recently fentanyl analogous, AH-7921, MT-45 and now U-47700 have been encountered in clinical and forensic casework. U-47700 is gaining popularity on drug user forms as a legal alternative to heroin...
December 29, 2016: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/27670723/-purple-drank-a-dangerous-cocktail
#7
L Garcin, M Le Roch, C-A Agbessi, J-B Lobut, A Lecoeur, G Benoist
"Purple drank" is a dangerous hallucinogenic cocktail commonly used by teenagers, made popular by American rappers and social networks. It combines codeine-based cough syrup, antihistamines such as promethazine, and soda. Unknown by caregivers, it may be responsible for serious neuropsychological complications. We report the effects of this new risky behavior in three patients: a 14-year-old girl and her boyfriend, both found in an initial state of drowsiness, followed by hallucinations and anticholinergic toxidrome; and another teenager whose chronic use led to addiction with increasing doses...
November 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/27335364/challenges-in-a-large-mixed-drug-overdose-patient
#8
Paige Zhang, Emily Austin, Margaret Thompson, Steve Lin
A 39-year-old homeless man was found confused and incoherent after ingesting an estimated total of 200 tablets of various medications. He presented to the emergency department with delirium, tachycardia, clonus and hyperthermia of 38.0°C. His condition worsened rapidly with his temperature rising to 39.9°C despite active cooling. The patient was subsequently sedated, intubated, paralysed and admitted to the intensive care unit, where he remained for 38 days. His initial presentation of a large mixed drug overdose manifested as serotonin syndrome, which had a protracted course complicated by ethanol withdrawal...
June 22, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27288091/recreational-use-of-dextromethorphan-robotripping-a-brief-review
#9
Cornel N Stanciu, Thomas M Penders, Eden M Rouse
BACKGROUND: Dextromethorphan (DXM) in combination with antihistamines and/or pseudoephedrine is widely available as an over-the counter remedy commonly used for relief of colds and cough. In supra-therapeutic amounts, DXM has psychoactive effects. These cough preparations have been adopted by many young users of recreational drugs for these effects. OBJECTIVES: This paper aims to highlight the increasingly prevalent practice of Robotripping, review pharmacokinetic and dynamic data and discuss potential tolerance and withdrawal from the substance as well as treatment modalities...
August 2016: American Journal on Addictions
https://www.readbyqxmd.com/read/27277955/an-infant-with-a-prolonged-sympathomimetic-toxidrome-after-lisdexamfetamine-dimesylate-ingestion
#10
Kelly E Wood, Matthew D Krasowski
INTRODUCTION: Stimulant medications are approved to treat attention deficit hyperactivity disorder (ADHD) in children over the age of 6 years. Fatal ingestion of stimulants by children has been reported, although most ingestions do not result in severe toxicity. Lisdexamfetamine dimesylate, a once daily long-acting stimulant, is a prodrug requiring conversion to its active form, dextroamphetamine, in the bloodstream. Based on its unique pharmacokinetics, peak levels of d-amphetamine are delayed...
December 2016: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/27266642/-acute-poisoning-by-pesticides-in-children
#11
P Leveau
Acute pesticide poisoning in children is rare but potentially serious. Some clinical patterns (toxidromes) are suggestive of the drug class: cholinergic crisis for organophosphate or carbamate insecticides; neurological syndrome for rodenticides; digestive and respiratory syndrome for herbicides. Treatment is symptomatic and only a few patients are treated with an antidote: atropine and pralidoxime for organophosphate insecticides, vitamin K for anticoagulant rodenticides.
July 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/27020994/a-45-year-old-woman-with-an-anticholinergic-toxidrome
#12
N A F Verheijden, B C Koch, Z Brkic, J Alsma, S C E Klein Nagelvoort-Schuit
Intentional or accidental intoxications are common in the emergency department, but are not always sufficiently recognised. When intoxication is suspected, the causative agent or combination of agents often remain unclear, making these patients a diagnostic challenge. We present here a 45-year-old woman who was admitted due to altered consciousness. The clinical presentation fitted the anticholinergic toxidrome and an intoxication with venlafaxine (her known prescribed medication) was suspected. Plasma venlafaxine concentrations, however, were very low...
March 2016: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/26948561/poisoning-by-herbs-and-plants-rapid-toxidromic-classification-and-diagnosis
#13
REVIEW
James H Diaz
The American Association of Poison Control Centers has continued to report approximately 50,000 telephone calls or 8% of incoming calls annually related to plant exposures, mostly in children. Although the frequency of plant ingestions in children is related to the presence of popular species in households, adolescents may experiment with hallucinogenic plants; and trekkers and foragers may misidentify poisonous plants as edible. Since plant exposures have continued at a constant rate, the objectives of this review were (1) to review the epidemiology of plant poisonings; and (2) to propose a rapid toxidromic classification system for highly toxic plant ingestions for field use by first responders in comparison to current classification systems...
March 2016: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/26897424/pharmacologic-strategies-for-treatment-of-poisonings
#14
REVIEW
Eric Roberts, Michael D Gooch
Poisoning is the leading cause of injury-related mortality in the United States. Data suggest that nonmedical use of pharmaceuticals is increasing, along with a proportional increase in subsequent adverse events. The widespread use of illegal drugs contributes to the challenge, because these drugs may produce a wide array of clinical presentations that warrant time-critical recognition and treatment. Common legal and illegal poisonings highlighting clinical presentations in terms of toxidromes as a means of categorically recognizing these emergencies is the focus of this article...
March 2016: Nursing Clinics of North America
https://www.readbyqxmd.com/read/26847479/-cathinones-use-in-paris
#15
A Batisse, M Grégoire, M Marillier, M Fortias, S Djezzar
BACKGROUND: The pattern of recreational drug use has changed over the last decade and now includes a multitude of substances sold as "research chemicals" or new psychoactive substances, "NPS". In France, synthetic cathinones emerged in 2008 (while first mentioned by the French police force in 2007 first alerts among users appeared in 2008) and have grown to be popular drugs of abuse. Under the Official Journal dated 11th June 2010, only mephedrone has been listed as narcotics but "designer drugs" have synthesized new substitute cathinones in order to avoid anti-drug laws...
August 2016: L'Encéphale
https://www.readbyqxmd.com/read/26726791/legal-highs-lethal-lows
#16
Bhavini Shah, Tom Heaps
Novel Psychoactive Substances (NPS), sometimes referred to as Legal Highs, are newly available drugs with psychoactive properties that are not currently prohibited by United Nations Drug Conventions. Despite many of these compounds still being 'legal' and readily available via online mail-order companies and high-street 'headshops', their rapid emergence in the UK has been associated with increasing hospital admissions, enquiries on TOXBASE® and fatalities. It is therefore vital that Acute Physicians have a good understanding of the issues in recognizing, investigating and managing patients presenting to the AMU with toxicity due to legal highs...
2015: Acute Medicine
https://www.readbyqxmd.com/read/26709671/focused-use-of-drug-screening-in-overdose-patients-increases-impact-on-management
#17
Andreas Erdmann, Dominique Werner, Olivier Hugli, Bertrand Yersin
UNLABELLED: Drug poisoning is a common cause for attendance in the emergency department. Several toxicology centres suggest performing urinary drug screens, even though they rarely influence patient management. STUDY OBJECTIVES: Measuring the impact on patient management, in a University Emergency Department with approximately 40 000 admissions annually, of a rapid urinary drug screening test using specifically focused indications. Drug screening was restricted to patients having a first psychotic episode or cases demonstrating respiratory failure, coma, seizures, a sympathomimetic toxidrome, severe opiate overdose necessitating naloxone, hypotension, ventricular arrhythmia, acquired long QT or QRS >100 ms, and high-degree heart block...
2015: Swiss Medical Weekly
https://www.readbyqxmd.com/read/26691719/abuse-of-the-over-the-counter-antispasmodic-butylscopolamine-for-the-home-synthesis-of-psychoactive-scopolamine
#18
Sebastian Kummer, Annette Rickert, Thomas Daldrup, Ertan Mayatepek
UNLABELLED: We report on two patients who ingested psychoactive scopolamine that was synthesized at home from butylscopolamine (Buscopan®), which is available as over-the-counter antispasmodic in nearly 100 countries worldwide. Patient 1 presented with severe central anticholinergic toxidrome, while patient 2 suffered from minor symptoms. An empty blister of Buscopan® was found in the patients' home, but initially was not suspected to be causative for the observed central anticholinergic symptoms, as Buscopan® is not able to pass the blood-brain barrier in its native form...
July 2016: European Journal of Pediatrics
https://www.readbyqxmd.com/read/26613226/datura-stramonium-poisoning-in-a-child
#19
Ahmet Kağan Özkaya, Ekrem Güler, Nihal Karabel, Ali Rıza Namlı, Yalçın Göksügür
Hallucinogenic plant poisoning in children is a significant problem for the emergency physician. We describe the case of a boy who had slurred speech, fever, hallucinations, tachycardia, dilated pupils, confusion and disorientation. He had no history of drug use or toxin intake. All signs and symptoms were improved by supportive therapy within 48 hours. It turned out that the patient had ingested seeds of Datura stramonium in a neighbor's garden two days previously. The medical history should be taken repeatedly in cases of unknown etiology, and physicians should keep in mind the possibility that unexplained anticholinergic toxidromes could be the result of exposure to toxic plants, in particular those containing atropine and atropine derivates...
January 2015: Turkish Journal of Pediatrics
https://www.readbyqxmd.com/read/26587869/the-toxicology-of-new-psychoactive-substances-synthetic-cathinones-and-phenylethylamines
#20
REVIEW
Elli Tyrkkö, Mikael Andersson, Robert Kronstrand
BACKGROUND: New psychoactive substances (NPSs) are substitutes for classical drugs of abuse and there are now compounds available from all groups of classical drugs of abuse. During 2014, the number of synthetic cathinones increased dramatically and, together with phenylethylamines, they dominate the NPS markets in the European Union. In total, 31 cathinones and 9 phenylethylamines were encountered in 2014. The aim of this article was to summarize the existing knowledge about the basic pharmacology, metabolism, and human toxicology of relevant synthetic cathinones and phenylethylamines...
April 2016: Therapeutic Drug Monitoring
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