• Davide Lonati, Eleonora Buscaglia, Pietro Papa, Antonella Valli, Teresa Coccini, Andrea Giampreti, Valeria Margherita Petrolini, Sarah Vecchio, Giovanni Serpelloni, and Carlo Alessandro Locatelli.
• Poison Control Centre and National Toxicology Information Centre, Toxicology Unit, IRCCS Maugeri Foundation, Pavia, Italy. Electronic address: davide.lonati@fsm.it.
• Ann Emerg Med. 2014 Dec 1;64(6):629-32.

AbstractExcitatory behavior, xerostomia, chest pain, severe dyspnea, tachycardia (150 beats/min), and mild hypertension (160/80 mm Hg) without ECG abnormalities were observed in a 20-year-old subject 6 hours after nasal insufflation (snorting) of a "legally" obtained white powdered substance sold as Synthacaine. A serum sample was found to contain MAM-2201 (11 ng/mL), a synthetic cannabinoid receptor agonist, and benzocaine. The patient's symptoms improved after administration of diazepam and intravenous fluids. Synthacaine was sold as legal cocaine, suggesting the user can expect an effect like that of cocaine. The pharmacologic receptor profile and chemical structure of MAM-2201 is similar to the synthetic cannabinoid receptor agonists AM-2201 and JWH-122 (2 potent synthetic cannabinoid receptor agonists with high affinity to cannabinoid receptors).Copyright © 2014 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

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