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The aim was to characterize the acute toxicity of synthetic cannabinoids as experienced by emergency patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>This was a retrospective study targeting patients seeking emergency treatment after recreational use of synthetic cannabinoids.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting and participants<\/jats:title><jats:p>Patients were selected from the database of the Poisons Information Center<jats:styled-content style=\"fixed-case\">F<\/jats:styled-content>reiburg between September 2008 and February 2011. The inclusion criteria were: hospitalization, available clinical reports and analytical verification of synthetic cannabinoid uptake. In total, 29 patients were included (age 14\u201330 years, median 19; 25 males, four females).<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>Clinical reports were evaluated and synthetic cannabinoids and other drugs were determined analytically.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">CP<\/jats:styled-content>\u201047,497\u2010C8 (one),<jats:styled-content style=\"fixed-case\">JWH<\/jats:styled-content>\u2010015 (one),<jats:styled-content style=\"fixed-case\">JWH<\/jats:styled-content>\u2010018 (eight),<jats:styled-content style=\"fixed-case\">JWH<\/jats:styled-content>\u2010073 (one),<jats:styled-content style=\"fixed-case\">JWH<\/jats:styled-content>\u2010081 (seven),<jats:styled-content style=\"fixed-case\">JWH<\/jats:styled-content>\u2010122 (11),<jats:styled-content style=\"fixed-case\">JWH<\/jats:styled-content>\u2010210 (11),<jats:styled-content style=\"fixed-case\">JWH<\/jats:styled-content>\u2010250 (four) and<jats:styled-content style=\"fixed-case\">AM<\/jats:styled-content>694 (one) were quantified in blood samples.<jats:styled-content style=\"fixed-case\">JWH<\/jats:styled-content>\u2010018 was most common in 2008\u20139,<jats:styled-content style=\"fixed-case\">JWH<\/jats:styled-content>\u2010122 in 2010, and<jats:styled-content style=\"fixed-case\">JWH<\/jats:styled-content>\u2010210 in 2011. Tachycardia, agitation, hallucination, hypertension, minor elevation of blood glucose, hypokalaemia and vomiting were reported most frequently. Chest pain, seizures, myoclonia and acute psychosis were also noted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There appears to have been an increase in use of the extremely potent synthetic cannabinoids<jats:styled-content style=\"fixed-case\">JWH<\/jats:styled-content>\u2010122 and<jats:styled-content style=\"fixed-case\">JWH<\/jats:styled-content>\u2010210. Acute toxic symptoms associated with their use are also reported after intake of high doses of cannabis, but agitation, seizures, hypertension, emesis and hypokalaemia seem to be characteristic to the synthetic cannabinoids, which are high\u2010affinity and high\u2010efficacy agonists of the<jats:styled-content style=\"fixed-case\">CB<\/jats:styled-content><jats:sub>1<\/jats:sub>receptor. Thus, these effects are due probably to a strong<jats:styled-content style=\"fixed-case\">CB<\/jats:styled-content><jats:sub>1<\/jats:sub>receptor stimulation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1360-0443.2012.04078.x","type":"journal-article","created":{"date-parts":[[2012,9,13]],"date-time":"2012-09-13T09:19:32Z","timestamp":1347527972000},"page":"534-544","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":363,"title":["Acute toxicity due to the confirmed consumption of synthetic cannabinoids: clinical and laboratory findings"],"prefix":"10.1111","volume":"108","author":[{"given":"Maren","family":"Hermanns\u2010Clausen","sequence":"first","affiliation":[{"name":"Poisons Information Center Freiburg University Medical Center Freiburg Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Kneisel","sequence":"additional","affiliation":[{"name":"Institute of Forensic Medicine University Medical Center Freiburg Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bela","family":"Szabo","sequence":"additional","affiliation":[{"name":"Institute of Experimental and Clinical Pharmacology and Toxicology University of Freiburg Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Volker","family":"Auw\u00e4rter","sequence":"additional","affiliation":[{"name":"Institute of Forensic Medicine University Medical Center Freiburg Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,11]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"UNODC United Nations Office on Drugs and Crime.World Drug Report 2010.2011. 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