Halil DOĞAN, D. Niyazi ÖZÜÇELİK, KURTULUŞ AÇIKSARI, Akkan AVCI, Mustafa YAZICIOĞLU, M Ferudun ÇELİKMEN, Çağatay KARŞIDAĞ, Murat ERKIRAN, U Mert AKSOY

New synthetic cannabinoid intoxications in emergency department (It's grass, it's no sin)

Amaç: Bu çalışmanın amacı, son yıllarda dünyada ve Türkiye'deki acil başvurularında önemli artış gösteren yeni sentetik kanabinoid ürünleri olgularının acil başvurudaki klinik özelliklerini ve prognozunu zehirlenme ciddiyet puanı kullanarak değerlendirmektir. Yöntem: Acil servisimize 2012-2014 yılları arasında başvuran 272 olgu çalışmaya alındı. Tüm hastaların klinik ve laboratuar düzeyleri ile zehirlenme ciddiyet puanları geriye dönük olarak araştırıldı. Bulgular: Olguların yaş ortalaması 25.08±7.07 yıl ve bunların %97.4'ü erkekti. Tüm SCPs kullanan hastaların %44.11'i Ramazan ayında hastaneye gelmişti. Yeni sentetik kanabinoid ürünleri kullanan 272 hastadan %83.5'i Bonsai-18, %16.2'si Jamaika gold kullanmaktaydı. Baş dönmesi en yaygın fiziksel bulgu, ajitasyon en sık psikoaktif bir bulgu olarak saptanmıştı. En sık görülen belirti ve bulgular gastrointestinal sistemde görülmüştü. Hastaların çoğunun orta derecede zehirlenme ciddiyet puanı grubunda olduğu saptandı. Bir hasta çoklu organ yetmezliği nedeniyle 96 saat içinde ölürken, diğerleri şifa ile taburcu oldular. Tartışma: Yeni sentetik kanabinoid ürünleri kullanımına bağlı acil başvuruları giderek artmayı sürdürmüştür (Ramazan ayı dahil). Bu ürünler, hastalarda minör zehirlenme ciddiyet puanından ölümcül zehirlenme ciddiyet puanına kadar değişen farklı klinik belirti ve bulgulara neden olmaktadır. Bu hastaları ilk karşılayan ve izleyen acil servis ve psikiyatri doktorlarının bu yeni maddelerle ilgili daha fazla bilgiye gereksinmesi vardır. (Anadolu Psikiyatri Derg 2016; 17(1):18-25)

Acil serviste yeni sentetik kannabinoid zehirlenmeleri (Ottur, günahı yoktur)

Objective: The aim of this study is to evaluate prognosis and clinical futures of the subjects who use new synthetic cannabinoid products (SCPs) with Poisoning Severity Score (PSS) in the Emergency Department (ED). Methods: We retrospectively reviewed 272 cases which resorted, to our ED between 2012 and 2014. All patients' clinical, laboratory levels and the PSS were studied. Results: The average age of the subjects was 25.08±7.07 years and 97.4% of them were male. 44.11% of all SCPs patients came to hospital during Ramadan. Of the 272 patients using SCPs, 83.5% used Bonsai-18 while 16.2% of them used Jamaica gold. Agitation was the most common psychoactive finding while dizziness was the most common physical finding. The most common symptoms and findings were seen in the gastrointestinal system. Most of the patients were found to be in the moderate PSS group. There was no patient in the non PSS group. While one patient in the fatal PSS group died in the 96th hour due to failure of multiple organs, the others had been discharged. Conclusion: SCPs cases have been increasing gradually in EDs including Ramadan. Our study has shown that SCPs have different physical and psychoactive effects, changeable from minor-PSS to fatal PSS (death). Therefore ED and psychiatry physicians should have much more knowledge about these new SCPs. (Anatolian Journal of Psychiatry 2016; 17(1):18-25)

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