Myocardial Ischemia with Cannabinoid Use in an Adolescent

Mehta, Jeet; Mahendran, Arjun K.; Bajaj, Ravi R.; Doshi, Arpan R

doi:10.7759/cureus.1899

Cited by 8 publications

(8 citation statements)

References 6 publications

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“…However, many of these cases were attributed to synthetic cannabinoid use based solely on statements by patients or witnesses, without analytical confirmation of the identity and amount of substances in bodily fluids or remaining drug products. Severe clinical complications that have been reported to be associated with synthetic cannabinoid use include convulsions and seizures (Adamowicz et al 2017;Bäckberg et al 2017;Bebarta et al 2012 Yirgin et al 2018), pneumonia and pulmonary infiltrates (Alhadi et al 2013;Alon and Saint-Fleur 2017;Berkowitz et al 2015;Chinnadurai et al 2016;Ö cal et al 2016), respiratory depression (Alon and Saint-Fleur 2017; Jinwala and Gupta 2012), supraventricular and ventricular arrhythmias (Davis and Boddington 2015;Ibrahim et al 2014;Ozturk et al 2019;Young et al 2012), myocardial ischemia and infarction (Clark et al 2015;Hamilton et al 2017;Hirapara and Aggarwal 2015;McIlroy et al 2016;McKeever et al 2015;Mehta et al 2017;Mills et al 2018;Mir et al 2011;Ozturk et al 2019;Shah et al 2016;Sherpa et al 2015;Tse et al 2014), takotsubo cardiomyopathy (Mohammed 2019), liver injury (Shahbaz et al 2018), acute kidney injury (Argamany et al 2016;Armstrong et al 2019;Bhanushali et al 2013;Buser et al 2014;El Zahran et al 2019;Gudsoorkar and Perez 2015;Kamel and Thajudeen 2015;Katz et al 2016b;…”

Section: Adverse Effects Of Synthetic Cannabinoidsmentioning

confidence: 99%

Designer drugs: mechanism of action and adverse effects

2020

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Psychoactive substances with chemical structures or pharmacological profiles that are similar to traditional drugs of abuse continue to emerge on the recreational drug market. Internet vendors may at least temporarily sell these so-called designer drugs without adhering to legal statutes or facing legal consequences. Overall, the mechanism of action and adverse effects of designer drugs are similar to traditional drugs of abuse. Stimulants, such as amphetamines and cathinones, primarily interact with monoamine transporters and mostly induce sympathomimetic adverse effects. Agonism at l-opioid receptors and c-aminobutyric acid-A (GABA A) or GABA B receptors mediates the pharmacological effects of sedatives, which may induce cardiorespiratory depression. Dissociative designer drugs primarily act as N-methyl-D-aspartate receptor antagonists and pose similar health risks as the medically approved dissociative anesthetic ketamine. The cannabinoid type 1 (CB 1) receptor is thought to drive the psychoactive effects of synthetic cannabinoids, which are associated with a less desirable effect profile and more severe adverse effects compared with cannabis. Serotonergic 5-hydroxytryptamine-2A (5-HT 2A) receptors mediate alterations of perception and cognition that are induced by serotonergic psychedelics. Because of their novelty, designer drugs may remain undetected by routine drug screening, thus hampering evaluations of adverse effects. Intoxication reports suggest that several designer drugs are used concurrently, posing a high risk for severe adverse effects and even death.

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Section: Adverse Effects Of Synthetic Cannabinoidsmentioning

confidence: 99%

Designer drugs: mechanism of action and adverse effects

2020

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“…A recent study reported the fluctuations in the discharge medications dosing and length of stay in adult BD population using cannabis and synthetic cannabis [63]. With a dearth of such studies in young BD population and increased prevalence of synthetic cannabis use in the community [64][65][66], it is crucial to integrate this factor in adolescent BD patients for further insight.…”

Section: Discussionmentioning

confidence: 99%

Higher Prevalence of Metabolic Syndrome in Child-adolescent Patients with Bipolar Disorder

Mohite

Sharma

et al. 2020

Clin Psychopharmacol Neurosci

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Objective: Previous studies have indicated a convergent and bidirectional relationship between metabolic syndrome (MetS) and bipolar disorder (BD). As most of these studies focused mainly on adults diagnosed with BD, our study aims to investigate and characterize metabolic disturbances in child-adolescents diagnosed with BD. Methods: We retrospectively examined the medical records of psychiatric hospitalizations with admitting diagnosis of BD in child-adolescents (age ＜ 18 years). Body mass index (BMI), lipid profile, fasting blood glucose, and blood pressure were primary variables. National Cholesterol Education Program criteria were used to define MetS. Reference group data was obtained from the National Health and Nutrition Examination Survey study. Statistical analyses included t tests, chi-square tests, and Fisher's exact tests. Results: We identified 140 child-adolescent patients with BD (mean age = 15.12 ± 1.70 years, 53% male). MetS was significantly more common in BD compared to the reference group: 14% (95% confidence interval [95% CI] 8−20) vs. 6.7% (95% CI 4.1−9.2), p = 0.001 with no significant difference by sex. MetS components were higher in the BD group, particularly BMI ≥ 95% (25% vs. 11.8%, p ＜ 0.001) and high blood pressure (17% vs. 8%, p = 0.05). Moreover, female patients had lower odds of high blood pressure (odds ratio = 0.24 [95% CI 0.08−0.69], p = 0.005). Conclusion: Compared with the general child-adolescent population, the prevalence of MetS was significantly higher in patients with BD of same age. This reiterates the notion of an increased risk of MetS in patients diagnosed with BD; and thus, further exploration is warranted.

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“…Thirteen publications were identified; 4 oral cases including a lingua villosa nigra [182], a lichenoid eruption [183], a necrotic ulcer [184], and an acute uvulitis [185], 2 cases with skin-grafts compromise [186,187], 2 cases of coronary events [188,189] in 16 and 24 year-old males, 1 case of neonatal necrotizing enterocolitis due to in-utero exposure [190], and 1 case of polycythemia [191]. Finally, in one case the e-cigarette use was attributed an anti-inflammatory [192] and in 2 cases an antibacterial [193,194] effect.…”

Section: Additional Diagnoses and Health Effects Attributed To Electrmentioning

confidence: 99%

A Systematic Literature Review of E-Cigarette-Related Illness and Injury: Not Just for the Respirologist

Tzortzi

Kapetanstrataki

Evangelopoulou

et al. 2020

IJERPH

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Following the recent electronic cigarette (e-cigarette) illness outbreak, the current review aimed to collect all related clinical cases for study and analysis and provide a critical synopsis of the proposed injury mechanism. Adhering to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analysis) guidelines, e-cigarette-related clinical cases were identified via Google Scholar and PubMed databases. Additionally, references of published case reports and previous review papers were manually searched, revealing 159 publications presenting e-cigarette-related case reports and 19 reports by the Centers for Disease Control and Prevention. 238 individual cases were identified; 53% traumatic injuries due to e-cigarette explosion or self-combustion, 24% respiratory cases, and 12% poisonings. Additional cases pertained to oral, cardiovascular, immunologic, hematologic, allergic reactions, infant complications, and altered medication levels. Case reports were mainly published between 2016–2019 (78%). The oldest case, a lipoid pneumonia, was published in 2012. The current review showed that e-cigarette-related health effects extend beyond the acute lung injury syndrome, including traumatic, thermal injuries and acute intoxications. Physicians should be aware of the distinct clinical presentations and be trained to respond and treat effectively. Regulators and public health authorities should address the regulatory gap regarding electronic nicotine delivery systems (ENDS) and novel tobacco products.

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Myocardial Ischemia with Cannabinoid Use in an Adolescent

Cited by 8 publications

References 6 publications

Designer drugs: mechanism of action and adverse effects

Designer drugs: mechanism of action and adverse effects

Higher Prevalence of Metabolic Syndrome in Child-adolescent Patients with Bipolar Disorder

A Systematic Literature Review of E-Cigarette-Related Illness and Injury: Not Just for the Respirologist

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