Clinical toxicology : the official journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists
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Clin Toxicol (Phila) · Sep 2019
The utility of droperidol in the treatment of cannabinoid hyperemesis syndrome.
Introduction: Cannabinoid hyperemesis syndrome (CHS) can be characterized by recurrent paroxysmal episodes of intractable nausea and vomiting, abdominal pain, and compulsive hot showers/baths with symptom relief, on the background of chronic cannabis use. We reported the use of droperidol in the management of CHS. Methods: We performed a retrospective review of electronic medical records of Emergency Department presentations to a single tertiary level metropolitan hospital between January 2006 and December 2016 using search keywords: "cannabis", "cannabinoid", "cannabis", "hyperemesis", and "droperidol". ⋯ The most frequent dosage of droperidol used was 0.625mg intravenously. The frequency of ondansetron (n = 100) and metoclopramide (n = 27) in the no droperidol treatment group was double that of the droperidol group. Conclusions: Use of droperidol to treat CHS associated nausea and vomiting resulted in less overall use of antiemetics and reduced length of stay.
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Clin Toxicol (Phila) · Sep 2019
Case ReportsNew synthetic opioid cyclopropylfentanyl together with other novel synthetic opioids in respiratory insufficient comatose patients detected by toxicological analysis.
Introduction: Fentanyl derivatives like cyclopropylfentanyl have recently appeared on the recreational drug market. Cyclopropylfentanyl is probably a highly potent opioid, but human toxicological data are not available so far. Similar to other fentanyl derivatives the most serious acute health risk due to the use of cyclopropylfentanyl is likely to be respiratory depression. ⋯ The ingested substance, as well as the excreted metabolites, were detected by application of various mass spectrometric techniques. Conclusions: In cases of intoxication without a medical history, the detailed toxicological analysis may reveal new psychoactive substances which are not detected by standard toxicological screening approaches. The high pharmacological potency of new products with unknown toxicological data and unknown synergistic effects may easily lead to a life-threatening overdose.