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Synthetic cannabinoids
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				Contents
Background
- Common street names: spice, K2, Moon Rocks, Blue Lotus, many others
 - Active ingredients frequently change to avoid legal proscription
 - Generally contains cannabinoid receptor agonists (CB1 or CB2) that are far more potent than THC
 - Does not show up on routine tox screen
 - Generally smoked, but can be imbibed as a tea
 
Clinical Features
- Similar effect to marijuana at low doses, but may be more intense and cause an acute Excited delirium
 - Typical onset of 10-30 min and taper over 1-2 hours
 - Tachycardia and hypertension common (distinguishing it from MJ use)
 - Adverse effects:;nausea, vomiting, diaphoresis, anxiety, paranoia, hallucinations, agitation, deli
 - Use has been associated with AKI and acute cerebral ischemia.[1][2]
 
Differential Diagnosis
Sympathomimetics
- Cocaine
 - Amphetamines
 - Ketamine
 - Ecstasy (MDMA)
 - Synthetic cannabinoids
 - Bath salts
 
Drugs of abuse
- Cocaine
 - Ecstasy
 - Marijuana
 - Amphetamines
 - Alcohol
 - Synthetic cannabinoids
 - Bath salts
 - Heroin
 - 25C-NBOMe
 - Inhalant abuse
 - Gamma hydroxybutyrate (GHB)
 - Phencyclidine (PCP)
 - Psilocybin (magic mushrooms)
 
Evaluation
- Clinical diagnosis
 
Management
- Supportive care
 
Disposition
- Generally may be discharged once sober (assuming no adverse effects that would mandate admission)
 
See Also
References
- ↑ Buser GL, Gerona RR, Horowitz BZ, et al. Acute kidney injury associated with smoking synthetic cannabinoid. Clin Toxicol (Phila). 2014;52(7):664–73.
 - ↑ Takematsu M, Hoffman RS, Nelson LS, Schechter JM, Moran JH, Wiener SW. A case of acute cerebral ischemia following inhalation of a synthetic cannabinoid. Clin Toxicol (Phila). 2014;52(9):973–5.
 
