Synthetic cannabinoids: the multi-organ failure and metabolic derangements associated with getting high

Abstract

Synthetic cannabinoids (SC), though not detected with routine urine toxicology screening, can cause severe metabolic derangements and widespread deleterious effects in multiple organ systems. The diversity of effects is related to the wide distribution of cannabinoid receptors in multiple organ systems. Both cannabinoid-receptor-mediated and non-receptor-mediated effects can result in severe cardiovascular, renal, and neurologic manifestations. We report the case of a 45-year-old African American male with ST-elevation myocardial infarction, subarachnoid hemorrhage, reversible cardiomyopathy, acute rhabdomyolysis, and severe metabolic derangement associated with the use of K2, an SC. Though each of these complications has been independently associated with SCs, the combination of these effects in a single patient has not been heretofore reported. This case demonstrates the range and severity of complications associated with the recreational use of SCs. Though now banned in the United States, use of systemic cannabinoids is still prevalent, especially among adolescents. Clinicians should be aware of their continued use and the potential for harm. To prevent delay in diagnosis, tests to screen for these substances should be made more readily available.

Rhabdomyolysis and Renal Insufficiency Due to Synthetic Cannabinoid Intoxication

“…They made a total of 10 dialysis sessions. In the case published by Sherpa et al (5), CK was increased to 302000 on the seventh day of hospitalization. Furthermore, SC metabolites were considered to contribute to the increase of CK.…”

Pneumomediastinum: A Complication of Synthetic Cannabinoid K2 Use

“…All these can lead to multi-organ dysfunction, acute kidney injury and severe rhabdomyolysis [1][2][3][13][14][15][16][17][18]. Cannabinoids have also been found to have caused fulminant liver failure and pulmonary edema [14].…”

“…Cannabinoids have also been found to have caused fulminant liver failure and pulmonary edema [14]. Neuropsychiatric effects include confusion, agitation, aggression, psychosis and dependence [2,[15][16][17][18][19]. K2 or spice, one of the formulations of SCs causes tachycardia, diaphoresis, conjunctival injection, hypokalemia and seizures [20,21].…”

What is the Current Knowledge About the Cardiovascular Risk for Users of Cannabis-Based Products? A Systematic Review

“…The mean age was 31 years (95%CI = 29-34). There were five cases of thromboangiitis obliterans [16,28,33,50,82], four hemorrhagic strokes [36,37,72,73], and two episodes of myopericarditis [55,85]. Heart rate and blood pressure for both genders were provided in 40 and 43 cases, respectively.…”