NÜKHET ALADAĞ ÇİFTDEMİR, İlay YÜCEL, Rıdvan DURAN, Ülfet VATANSEVER-ÖZBEK, Betül ACUNAŞ

A new emerging problem in pediatric emergency units: Synthetic cannabinoids

Aladağ-Çiftdemir N, Yücel İ, Duran R, Vatansever-Özbek Ü, Acunaş B. A new emerging problem in pediatric emergency units: Synthetic cannabinoids. Turk J Pediatr 2016; 58: 492-497.Synthetic cannabinoids or synthetic marijuana derivatives known as "Bonzai" in Turkey are addictive substances that affect the brain and have serious side effects. In recent years, the use of these substances has also been increasing in our country as well as all over the world. These substances present with various names and brands, the most common names in Turkey are "Bonzai" and "Jamaika". In this study, we aimed to evaluate the demographic and clinical findings of these patients. We retrospectively evaluated patients admitted to our pediatric emergency department between March 2013 and March 2015 due to the complaints developing after the use of "Bonzai" in terms of age, gender, admission date, complaint, clinical findings, laboratory findings, consuming method of the substance, additional substance use, observation durations, hospitalization status and mortality rates. The most common complaint was faintness and drowsiness. Changes in the state of consciousness, tachycardia, hypertension were the most common clinical findings. Most common consuming method of the drug was in the form of smoking. The rate of "Bonzai" use among adolescents is increasing every day. Physicians in emergency departments should be educated on this issue and it must be kept in mind that most of the patients admitted are with complaints related to changes in the cognitive state (of consciousness) but they can also apply with complaints about all other systems.

PDF

___

1. Artuç S, Doğan KH, Demirci Ş. Uyuşturucu maddelerde yeni trend: Sentetik Kannabinoidler. Adli Tıp Bülteni 2014; 19: 198-203.

2. Ergül DF, Ekemen S, Büyükkıdan Yelken B. Sentetik kannabinoid 'Bonzai' intoksikasyonu: Altı olgu serisi. Türk Anestezi ve Reanimasyon Dergisi 2015; 43: 347- 351.

3. Kalyoncu ÖA, Ünlü B, Taştan U. Gençlerin tehlikeli oyunu: Sentetik kannabinoidler (Bonzai) üzerine bir gözden geçirme. Bağımlılık Dergisi 2014; 15: 150-155.

4. Gurdal F, Asirdizer M, Aker RG, et al. Review of detection frequency and type of synthetic cannabinoids in herbal compounds analyzed by Istanbul Narcotic Department of the Council of Forensic Medicine, Turkey. J Forensic Leg Med 2013; 20: 667-672.

5. Rella JG. Recreational cannabis use: Pleasures and pitfalls. Cleveland Clin J Med 2015; 82: 765-772.

6. http://www.emcdda.europa.eu/attachements.cfm/ att_212361_EN_EMCDDA_POD_2013_ Synthetic%20 cannabinoids.pdf. (Accessed: February 10, 2016).

7. Besli GE, Ikiz MA, Yildirim S, et al. Synthetic Cannabinoid Abuse in Adolescents: A Case Series. J Emerg Med 2015; 49: 644-650.

8. Bozkurt M, Umut G, Evren C, et al. Sentetik kannabinoid kullanımı nedeniyle polikliniğe başvuran hastaların klinik özellikleri ve laboratuvar sonuçları. Düşünen Adam: Psikiyatri ve Nörolojik Bilimler Dergisi 2014; 27: 328-334.

9. Hudson S.,Ramsey J, King L, et al. Use of highresolution accurate mass spectrometry to detect reported and previously unreported cannabinomimetics in "herbal high" products, J Anal Toxicol 2010; 34: 252-260.

10. Küçük E, Küçük İ, Kirazaldı YY. Acil serviste yeni bir tehlike: Sentetik kannabinoidler (Bonzai, Jameika). Genel Tıp Dergisi 2015; 25: 18-22.

11. Seely KA, Patton AL, Moran CL, et al. Forensic investigation of K2, Spice, and ''bath salt'' commercial preparations: A three-year study of new designer drug products containing synthetic cannabinoid, stimulant, and hallucinogenic compounds. Forensic Sci Int 2013; 233: 416-422.

12. Harris CR, Brown A. Synthetic cannabinoid intoxication: a case series and review. J Emerg Med 2013; 44: 360- 336.

13. Thornton SL, Akpunonu P, Glauner K, et al. Unintentional pediatric exposure to synthetic cannabinoid (AB-PINACA) resulting in coma and intubation. Ann Emerg Med 2015; 66: 343-344.

14. Lavi E, Rekhtman D, Berkun Y, et al. Sudden onset unexplained encephalopathy in infants: think of cannabis intoxication. Eur J Pediatr 2016; 175: 417- 420.

15. Forrester MB. Adolescent synthetic cannabinoid exposures reported to Texas poison centers. Pediatr Emerg Care 2012; 28: 985-989.

16. Aryana A, Williams MA. Marijuana as a trigger of cardiovascular events: speculation or scientific certainty? Int J Cardiol 2007; 118: 141-144.

17. Wolff V, Lauer V, Rouyer O, et al. Cannabis use, ischemic stroke, and multifocal intracranial vasoconstriction: a prospective study in 48 consecutive young patients. Stroke 2011; 42: 1778-1780.

18. Centers for Disease Control and Prevention (CDC). Acute kidney injury associated with synthetic cannabinoid use - multiple states, 2012. MMWR Morb Mortal Wkly Rep 2013; 62: 939-948.

19. Buser GL, Gerona RR, Horowitz BZ, et al. Acute kidney injury associated with smoking synthetic cannabinoid. Clin Toxicol (Phila) 2014; 52: 664-673.

20. Tait RJ, Caldicott D, Mountain D, et al. A systematic review of adverse events arising from the use of synthetic cannabinoids and their associated treatment. Clin Toxicol (Phila) 2016; 54: 1-13.

21. Duran D, Delgado LL, de la Parra-Pellot DM, et al. Psychosis and severe rhabdomyolysis associated with synthetic cannabinoid use: a case report. Clin Schizophr Relat Psychoses 2015; 4: 205-208.

22. Roberts JR. Synthetic cannabinoids: treating toxicity. Emerg Med News 2015; 37: 12-14.