Hemorrhagic Soft Tissue Upper Airway Obstruction From Brodifacoum-Contaminated Synthetic Cannabinoid

Ross, C. H.; Singh, Parvinder; Simon, Erin L.

doi:10.1016/j.jemermed.2019.03.007

Cited by 9 publications

(5 citation statements)

References 8 publications

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“…Importantly, the aforementioned adverse effects associated with SCRA use are not typically observed following cannabis consumption . Cases of coagulopathies following SCRA consumption in the United States have recently been linked to the presence of a potent vitamin K antagonist (brodifacoum [ 9 ]) in certain batches of SCRA‐containing products . At present, it remains unclear if this presence of 9 in certain batches of SCRA‐containing products is deliberate or accidental.…”

Section: Introductionmentioning

confidence: 99%

Adding more “spice” to the pot: A review of the chemistry and pharmacology of newly emerging heterocyclic synthetic cannabinoid receptor agonists

Alam

Keating

2020

Drug Testing and Analysis

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Synthetic cannabinoid receptor agonists (SCRAs) first appeared on the international recreational drug market in the early 2000s in the form of SCRA‐containing herbal blends. Due to the cannabimimetic effects associated with the consumption of SCRAs, they have acquired an ill‐informed reputation for being cheap, safe, and legal alternatives to illicit cannabis. Possessing high potency and affinity for the human cannabinoid receptor subtype‐1 (CB1) and ‐2 (CB2), it is now understood that the recreational use of SCRAs can have severe adverse health consequences. The major public health problem arising from SCRA use has pressed legislators around the world to employ various control strategies to curb their recreational use. To circumvent legislative control measures, SCRA manufacturers have created a wide range of SCRA analogs that contain, more recently, previously unencountered azaindole, γ‐carbolinone, or carbazole heterocyclic scaffolds. At present, little information is available regarding the chemical syntheses of these newly emerging classes of SCRA, from a clandestine perspective. When compared with previous generations of indole‐ and indazole‐type SCRAs, current research suggests that many of these heterocyclic SCRA analogs maintain high affinity and efficacy at both CB1 and CB2 but largely evade legislative control. This review highlights the importance of continued research in the field of SCRA chemistry and pharmacology, as recreational SCRA use remains a global public health issue and represents a serious control challenge for law enforcement agencies.

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Section: Introductionmentioning

confidence: 99%

Adding more “spice” to the pot: A review of the chemistry and pharmacology of newly emerging heterocyclic synthetic cannabinoid receptor agonists

Alam

Keating

2020

Drug Testing and Analysis

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“…Intoxication can be severe including psychosis, respiratory depression, cardiac arrest, nephrotoxity, hyperemesis, rhabdomyolysis, hyperthermia, seizures, and cerebral ischemia (33). The most lethal adulterant of synthetic cannabinoids is brodifacoum, a vitamin K-dependent antagonist (34,35). It is used to enhance the effects because of longer periods of lipid storage, hepatic metabolism, and slow release.…”

Section: Cannabismentioning

confidence: 99%

“…It is used to enhance the effects because of longer periods of lipid storage, hepatic metabolism, and slow release. Compared to the anticoagulation of warfarin it is 100 times greater and has a longer half-life of 20-130 days (35).…”

Section: Cannabismentioning

confidence: 99%

Diagnosis and management of the patient with contaminated illicit drug poisoning

Pino,

McGrew

2023

Front. Anesthesiol.

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The diagnosis and management of poisoning is essential in critical care medicine. Traditionally, these conditions fall under the category of toxidromes that are the signs and symptoms associated with a particular class of poisons. However, there has been a steady increase in designer drugs and contaminants of recreational drugs themselves. Examples of adulterants in cocaine include the local anesthetic benzocaine and the anti-parasitic levamisole. This paper presents the clinical signs, laboratory findings, and treatment of patients who have been exposed to these substances.

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“…He continues to consume marijuana honey as of his last recorded outpatient visit. A literature review was conducted on PubMed using the terms "(marijuana) AND warfarin," "(cannabis) AND warfarin," "(marijuana) AND INR," and "(cannabis) AND INR," which yielded nine articles consisting of case reports, systematic reviews, and in vitro studies [1][2][3][4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

“…One article was excluded as it was written in Polish. Among those included is a study detailing a March to April 2018 coagulopathy outbreak in the setting of synthetic cannabinoid use tainted with brodifacoum, a vitamin K antagonist used as rodenticide [1]. A 1997 case report similarly described brodifacoum laced marijuana causing vitamin-K dependent coagulopathy [2].…”

Section: Introductionmentioning

confidence: 99%

Small Bowel Hematoma in the Setting of Concurrent Warfarin and Cannabis Use

Maldonado

2019

GMR

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Hemorrhagic Soft Tissue Upper Airway Obstruction From Brodifacoum-Contaminated Synthetic Cannabinoid

Cited by 9 publications

References 8 publications

Adding more “spice” to the pot: A review of the chemistry and pharmacology of newly emerging heterocyclic synthetic cannabinoid receptor agonists

Adding more “spice” to the pot: A review of the chemistry and pharmacology of newly emerging heterocyclic synthetic cannabinoid receptor agonists

Diagnosis and management of the patient with contaminated illicit drug poisoning

Small Bowel Hematoma in the Setting of Concurrent Warfarin and Cannabis Use

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