Clinical experience with and analytical confirmation of “bath salts” and “legal highs” (synthetic cathinones) in the United States

@article{Spiller2011ClinicalEW,
  title={Clinical experience with and analytical confirmation of “bath salts” and “legal highs” (synthetic cathinones) in the United States},
  author={Henry A. Spiller and Mark Ryan and Robert G Weston and J Jansen},
  journal={Clinical Toxicology},
  year={2011},
  volume={49},
  pages={499 - 505}
}
UNLABELLED Recently, there has been a worldwide rise in the popularity and abuse of synthetic cathinones. [] Key MethodMETHOD This was a retrospective case series of patients reported to two poison centers with exposures to bath salts. Additionally, 15 "product samples" were obtained and analyzed for drug content using GC/MS. RESULTS There were 236 patients of which 184 (78%) were male. Age range was 16-64 years (mean 29 years, SD 9.4). All cases were intentional abuse.

“Bath Salts” and “Plant Food” Products: the Experience of One Regional US Poison Center

TLDR
Clinical effects associated with “bath salt” and “plant food” exposures as reported to the poison center serving the state of North Carolina are described and sedation with benzodiazepines, aggressive cooling for hyperthermic patients, and use of small doses of antipsychotics for choreoathetoid movements are not likely to be harmful.

Clinical Toxicology and Management of Intoxications With Synthetic Cathinones (“Bath Salts”)

TLDR
Recommendations are developed that may be useful to determine the treatment of patients after taking synthetic cathinones who show signs and symptoms of the sympathicomimetic toxidrome, including agitation, psychosis, tachycardia, hypertension, and seizures.

Bath Salt Use: A Case Report and Review of the Literature

TLDR
The use of bath salt is reported in a patient with a history of schizophrenia and comorbid methamphetamine dependence to encourage the continuing ban on the sale of bath salts and also educate both clinicians and patients about the risks of using such drugs.

“Bath Salts” the New York City Medical Examiner Experience: A 3‐Year Retrospective Review

TLDR
“Bath salts” are synthetic derivatives of cathinones, compounds found in the leaves of Catha edulis, which possesses amphetamine‐like properties, and lethal concentrations ofCathinones cannot be established.

Synthetic cathinone poisoning from ingestion of drug-laced “instant coffee packets” in Taiwan

TLDR
Patients who report ingesting toxic coffee packets are very likely to have been exposed to synthetic cathinones, and Polysubstance exposure is common following ingestion.

Methylenedioxypyrovalerone (“Bath Salts”),Related Death: Case Report and Review of the Literature ,

TLDR
Testing for 3,4‐methylenedioxypyrovalerone should be considered in cases with a history of polysubstance abuse with stimulant type drugs, report of acute onset of psychogenic symptoms, excited delirium syndrome, or presentation in a hyperthermic state.

Synthetic cathinones in Southern Germany – characteristics of users, substance-patterns, co-ingestions, and complications

TLDR
It is concluded that in the setting “typical” cathinone users are males in their thirties who are seldom drug naïve and regularly co-ingest illicit drugs.

Bath Salts in the Emergency Department: A Survey of Emergency Clinicians' Experience With Bath Salts-Intoxicated Patients

TLDR
The study demonstrates the need for increased screening of bath salts intoxication in EDs, especially in agitated patients, and suggests intravenous/intramuscular tranquilization was reported as the most often used management.

"Bath salts" intoxication: a new recreational drug that presents with a familiar toxidrome.

TLDR
A case report is presented and bath salts intoxication and its anticipated sympathomimetic toxidrome is discussed, treatment strategies, and toxicologic analysis are discussed, and physicians should not misconstrue a negative toxicology screen as evidence of no exposure to synthetic cathinones.
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