Analysis and clinical findings of cases positive for the novel synthetic cannabinoid receptor agonist MDMB-CHMICA

@article{Seywright2016AnalysisAC,
  title={Analysis and clinical findings of cases positive for the novel synthetic cannabinoid receptor agonist MDMB-CHMICA},
  author={Alice Seywright and Hazel J. Torrance and Fiona M Wylie and Denise A. McKeown and David J. Lowe and Richard Stevenson},
  journal={Clinical Toxicology},
  year={2016},
  volume={54},
  pages={632 - 637}
}
Abstract Context: MDMB-CHMICA is a synthetic cannabinoid receptor agonist which has caused concern due to its presence in cases of adverse reaction and death. Method: 43 cases of suspected synthetic cannabinoid ingestion were identified from patients presenting at an Emergency Department and from post-mortem casework. These were subjected to liquid-liquid extraction using tertiary-butyl methyl ether and quantitatively analysed by Electrospray Ionisation Liquid Chromatography–tandem Mass… 
Analytically Confirmed Intoxications Involving MDMB-CHMICA from the STRIDA Project
TLDR
The association with severe adverse reactions in nine acute analytically confirmed intoxication cases involving MDMB-CHMICA is consistent with other reports of serious toxicity linked to this substance, suggesting thatMDMB- CHMICA might be a particularly harmful SC.
Acute side effects after consumption of the new synthetic cannabinoids AB-CHMINACA and MDMB-CHMICA
TLDR
The valine derivative AB-CHMINACA and the tert-leucine derivative MDMB-CHMICA (“third generation of SCs”) seem to be associated with more severe clinical toxicity than was previously reported in patients exposed to earlier generation SCs such as JWH-018.
Post-Mortem Toxicology: A Systematic Review of Death Cases Involving Synthetic Cannabinoid Receptor Agonists
TLDR
Even after a comprehensive analysis of clinical, circumstantial, toxicological, and autoptic data, the cause and manner of death remain unclear in some cases.
Post-mortem distribution of the synthetic cannabinoid MDMB-CHMICA and its metabolites in a case of combined drug intoxication
TLDR
It was concluded from femoral blood analysis that the 27-year-old man found dead after falling from the 24th floor of a high-rise building was under the influence of the synthetic cannabinoid MDMB-CHMICA, THC, amphetamine and MDMA.
Poisoning due to MDMB-CHMICA, a synthetic cannabinoid receptor agonist
TLDR
The clinical course of three patients admitted under care from a local prison who were poisoned with MDMB-CHMICA are reported; all three patients developed hypercapnia, two had a reduced level of consciousness, two suffered seizures, and one was profoundly bradycardic (though propranolol was also detected on his drug screen).
Blood concentrations of synthetic cannabinoids
TLDR
The observed concentrations of SCs vary widely and often have overlapping ranges for fatal and non-fatal cases, therefore, a referenced compilation of concentration ranges would be useful.
Detection of the Synthetic Cannabinoids AB-CHMINACA, ADB-CHMINACA, MDMB-CHMICA, and 5F-MDMB-PINACA in Biological Matrices: A Systematic Review
TLDR
The objective of this study was to determine the best human biological matrices to detect the risk-assessed compounds provided by The European Monitoring Centre for Drugs and Drug Addiction: AB-CHMINACA, ADB-CHMNACA, MDMB-CHMICA, and 5F-MDMB-PINACA.
Phase I metabolism of the highly potent synthetic cannabinoid MDMB-CHMICA and detection in human urine samples.
TLDR
In this study, the in vivo phase I metabolism of MDMB-CHMICA was investigated using liquid chromatography-electrospray ionization-tandem mass spectrometry (LC-ESI-MS/MS) techniques and intrinsic activity of MDMICA at the CB1 receptor was determined applying a cAMP accumulation assay and showed that the compound is a potent full agonist.
Human Toxicity Caused by Indole and Indazole Carboxylate Synthetic Cannabinoid Receptor Agonists: From Horizon Scanning to Notification.
TLDR
A toxicovigilance system for NPS is described that predicted the emergence of misuse of indole and indazole carboxylate SCRA, documented associated clinical harms, and notified relevant agencies.
...
...

References

SHOWING 1-10 OF 23 REFERENCES
Toxicological findings of synthetic cannabinoids in recreational users.
TLDR
The toxicity of the synthetic cannabinoids seems to be worse than that of natural cannabis, probably owing to the higher potency and perhaps also to the presence of several different cannabinoids in the smoked incense and the difficulties of proper dosing.
SODAS: Surveillance of Drugs of Abuse Study
TLDR
Almost half of the presented patients revealed ingestion of multiple substances, which correlated poorly with self-reporting of patients, and developing enhanced strategies to monitor evolving drug trends is crucial to the ability of clinicians to deliver care to this challenging group of patients.
A systematic review of adverse events arising from the use of synthetic cannabinoids and their associated treatment
TLDR
To identify systematically the scientific reports of adverse events associated with the consumption of SCs in the medical literature and poison centre data, this work searched online databases and manually searched reference lists up to December 2014 to identify eligible studies.
Use of Synthetic Cannabinoids in Patients With Psychotic Disorders: Case Series
TLDR
This manuscript provides an overview and discussion of synthetic cannabinoids and presents four cases of patients with synthetic cannabinoid intoxication who were hospitalized in the authors' intensive psychiatric unit at the time of intoxication, with predominantly psychiatric adverse clinical effects.
Risk of emergency medical treatment following consumption of cannabis or synthetic cannabinoids in a large global sample
TLDR
Synthetic cannabinoids potentially pose a greater risk to users’ health than natural forms of cannabis, so well-informed user-focused health promotion messages need to be crafted to discourage their use.
Death due to diabetic ketoacidosis: Induction by the consumption of synthetic cannabinoids?
Synthetic cannabinoids
  • R. Bilici
  • Medicine
    Northern clinics of Istanbul
  • 2014
TLDR
Clinical effects of synthetic cannabinoids can cause referrals to emergency services, and hospitalizations, and despite lack of any specific therapy benzodiazepines, antipsychotics, and fluid replacement may be required.
Synthetic Cannabinoids
TLDR
More research is needed to identify which contaminants are typically found in synthetic marijuana and to understand the interactions between different SBCs to better predict adverse health outcomes.
Strategies for the assessment of matrix effect in quantitative bioanalytical methods based on HPLC-MS/MS.
TLDR
Practical, experimental approaches for studying, identifying, and eliminating the effect of matrix on the results of quantitative analyses by HPLC-MS/MS are described and it is demonstrated that, for the investigational drug under study, the matrix effect was clearly observed when ISP interface was utilized but it was absent when the HN interface was employed.
Marijuana-based drugs: innovative therapeutics or designer drugs of abuse?
TLDR
The K2/Spice "phenomenon" provides a context for considering whether marijuana-based drugs will truly provide innovative therapeutics or merely perpetuate drug abuse.
...
...