Abstract
There is no specific antidote for intoxication with synthetic cannabinoids. In this case series, we considered the efficiency of intravenous lipid emulsion therapy in four cases, who presented to emergency department with synthetic cannabinoid (bonzai) intoxication. The first patient had a GCS of 3 and a left bundle branch block on electrocardiography. The electrocardiography revealed sinus rhythm with normal QRS width after the treatment. The second patient had bradycardia, hypotension, and a GCS of 14. After intravenous lipid emulsion therapy, the bradycardia resolved, and the patient's GCS improved to 15. The third patient presented with a GCS of 8, and had hypotension and bradycardia. After the treatment, not only did the bradycardia resolve, but also the GCS improved to 15. The fourth patient, whose electrocardiography revealed accelerated junctional rhythm, had a GCS of 13. The patient's rhythm was sinus after the treatment. Cardiovascular recovery was seen in all four cases, and neurological recovery was also seen in three of them. Based on the fact that intravenous lipid emulsion is beneficial in patients intoxicated with lipophilic drugs, unstable patients presenting to the emergency department with acute synthetic cannabinoid intoxication may be candidates for intravenous lipid emulsion treatment.
Highlights
Since their introduction in 2004, synthetic cannabinoid (SC) receptor agonists have become increasingly popular as an abused substance, especially among adolescents [1, 2]
We aimed to discuss the efficiency of intravenous lipid emulsion (ILE) therapy through the examination of four cases presented to the emergency department (ED) after bonzai consumption, which is known to be a lipophilic toxin
A thirty-five-year-old man who was found lying on the floor unconscious with empty “bonzai” bags near him was brought to the ED by his family
Summary
Since their introduction in 2004, synthetic cannabinoid (SC) receptor agonists have become increasingly popular as an abused substance, especially among adolescents [1, 2] They are most commonly named as “spice” collectively, “bonzai” is new and the most commonly preferred definition in Turkey [3, 4]. ILE seems to be a new, safe, and promising treatment choice for SC intoxications. In this case series, we aimed to discuss the efficiency of ILE therapy through the examination of four cases presented to the emergency department (ED) after bonzai (spice) consumption, which is known to be a lipophilic toxin
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