■大麻是全球最常见的休闲药物,合成大麻素受体激动剂是目前最大的新型精神活性物质。这项研究的目的是比较孤立的急性大麻毒性与孤立的急性合成大麻素受体激动剂毒性的临床特征和结果,在2013年至2020年之间向欧洲急诊科进行的一系列介绍中。
■自我报告的药物暴露,临床,和结果数据来自欧洲药物紧急情况网络Plus,该网络是一个监测网络,记录向24个欧洲国家的36个中心提供的药物相关急诊科报告数据.在所有分析中,大麻暴露被认为是对照。为了比较单独的大麻和单独的合成大麻素受体激动剂组,使用卡方检验的单变量分析用于分类变量,而非参数Mann-WhitneyU检验用于连续变量。统计学显著性定义为P值<0.05。
■在2013-2020年之间,有54,314个与药物相关的陈述,其中2,657个是单独的大麻暴露和503个单独的合成大麻素受体激动剂暴露。合成大麻素受体激动剂的表现具有统计学上明显较高的嗜睡率,昏迷,激动,报告时的癫痫发作和心动过缓。大麻介绍明显更有可能出现心悸,胸痛,高血压,心动过速,焦虑,呕吐和头痛。
涉及单独的合成大麻素受体激动剂暴露的急诊科报告更有可能具有神经精神特征,并被送进精神科病房,单独接触大麻更有可能具有心血管特征。先前的研究表明,与大麻相比,合成大麻素受体激动剂的急性毒性存在差异,但很少有单独暴露的比较数据。目前的文献中,单独的合成大麻素受体激动剂和单独的大麻暴露之间的直接比较有限,只有两个以前的毒药中心系列和两个临床系列。虽然这项研究是有限的自我报告被用来确定药物(S)参与演示文稿,以前的研究表明,在急性药物毒性的急诊科报告中,自我报告是可靠的.
■这项研究直接比较了与单独使用大麻或合成大麻素受体激动剂有关的急性药物毒性的介绍。它支持先前的发现,与大麻相比,合成大麻素受体激动剂的神经精神毒性增加,并提供了有关单独使用大麻的心血管毒性的进一步数据。
UNASSIGNED: Cannabis is the most common recreational drug worldwide and synthetic cannabinoid receptor agonists are currently the largest group of new psychoactive substances. The aim of this
study was to compare the clinical features and outcomes of lone acute cannabis toxicity with lone acute synthetic cannabinoid receptor agonist toxicity in a large series of presentations to European emergency departments between 2013-2020.
UNASSIGNED: Self-reported drug exposure, clinical, and outcome data were extracted from the European Drug Emergencies Network Plus which is a surveillance network that records data on drug-related emergency department presentations to 36 centres in 24 European countries. Cannabis exposure was considered the control in all analyses. To compare the lone cannabis and lone synthetic cannabinoid receptor agonist groups, univariate analysis using chi squared testing was used for categorical variables and non-parametric Mann-Whitney U- testing for continuous variables. Statistical significance was defined as a P value of <0.05.
UNASSIGNED: Between 2013-2020 there were 54,314 drug related presentations of which 2,657 were lone cannabis exposures and 503 lone synthetic cannabinoid receptor agonist exposures. Synthetic cannabinoid receptor agonist presentations had statistically significantly higher rates of drowsiness, coma, agitation, seizures and bradycardia at the time of presentation. Cannabis presentations were significantly more likely to have palpitations, chest pain, hypertension, tachycardia, anxiety, vomiting and headache.
UNASSIGNED: Emergency department presentations involving lone synthetic cannabinoid receptor agonist exposures were more likely to have neuropsychiatric features and be admitted to a psychiatric ward, and lone cannabis exposures were more likely to have cardiovascular features. Previous studies have shown variability in the acute toxicity of synthetic cannabinoid receptor agonists compared with cannabis but there is little comparative data available on lone exposures. There is limited direct comparison in the current literature between lone synthetic cannabinoid receptor agonist and lone cannabis exposure, with only two previous poison centre series and two clinical series. Whilst this
study is limited by self-report being used to identify the drug(s) involved in the presentations, previous studies have demonstrated that self-report is reliable in emergency department presentations with acute drug toxicity.
UNASSIGNED: This
study directly compares presentations with acute drug toxicity related to the lone use of cannabis or synthetic cannabinoid receptor agonists. It supports previous findings of increased neuropsychiatric toxicity from synthetic cannabinoid receptor agonists compared to cannabis and provides further data on cardiovascular toxicity in lone cannabis use.