Supraventricular tachycardia and acute confusion following ingestion of e-cigarette fluid containing AB-FUBINACA and ADB-FUBINACA: a case report with quantitative analysis of serum drug concentrations
Introduction:
This text reports a case of supraventricular tachycardia (SVT) and acute confusion following ingestion of e-cigarette fluid containing AB-FUBINACA and ADB-FUBINACA. The article includes a quantitative analysis of the patient's serum drug concentrations. The reader will learn about the risks and toxic effects associated with the ingestion of synthetic cannabinoids.
Key points:
* The patient ingested e-cigarette fluid containing AB-FUBINACA and ADB-FUBINACA, leading to SVT and acute confusion.
* The patient's serum drug concentrations of AB-FUBINACA and ADB-FUBINACA were 5.6 ng/ml and 15.6 ng/ml, respectively.
* The study highlights the challenges clinicians face in managing synthetic cannabinoid poisoning and the need for maintaining a high index of suspicion for patients with similar presentations after recreational drug use.
* AB-FUBINACA and ADB-FUBINACA are orally bioavailable with rapid onset of cardiovascular and neurological toxicity after ingestion.
* The laboratory plays a pivotal role in analytical confirmation of synthetic cannabinoid use, and urinary metabolites may be a suitable marker for detecting exposure.
* In the context of acute poisoning, the presence of unexplained tachyarrhythmias, confusion, and a negative recreational drug screen should prompt clinicians to consider synthetic cannabinoid toxicity as a differential diagnosis.
Main message:
The study emphasizes the risks and toxic effects associated with synthetic cannabinoid use. The text highlights the importance of maintaining a high index of suspicion for synthetic cannabinoid poisoning in patients presenting with unexplained tachyarrhythmias, confusion, and negative recreational drug screens. The laboratory's role in analytical confirmation is crucial for accurate diagnosis and management of synthetic cannabinoid poisoning. The study also highlights the need for further research into the pharmacology and toxicology of synthetic cannabinoids to better understand their effects and improve patient outcomes.
Citation
Lam, Rex Pui Kin, Magdalene Huen Yin Tang, Siu Chung Leung, Yeow Kuan Chong, Matthew Sik Hon Tsui, and Tony Wing Lai Mak. “Supraventricular Tachycardia and Acute Confusion Following Ingestion of E-Cigarette Fluid Containing AB-FUBINACA and ADB-FUBINACA: A Case Report with Quantitative Analysis of Serum Drug Concentrations.” Clinical Toxicology 55, no. 7 (August 9, 2017): 662–67. https://doi.org/10.1080/15563650.2017.1307385.
Lam, Rex Pui Kin, Magdalene Huen Yin Tang, Siu Chung Leung, Yeow Kuan Chong, Matthew Sik Hon Tsui, and Tony Wing Lai Mak. “Supraventricular Tachycardia and Acute Confusion Following Ingestion of E-Cigarette Fluid Containing AB-FUBINACA and ADB-FUBINACA: A Case Report with Quantitative Analysis of Serum Drug Concentrations.” Clinical Toxicology 55, no. 7 (August 9, 2017): 662–67. https://doi.org/10.1080/15563650.2017.1307385.
