{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T22:20:12Z","timestamp":1772144412549,"version":"3.50.1"},"reference-count":20,"publisher":"The Pediatric Pharmacy Association","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023]]},"abstract":"<jats:sec>\n          <jats:title>OBJECTIVE<\/jats:title>\n          <jats:p>As a result of recent legislative changes allowing for increased access to marijuana products, there have been increasing rates of cannabis abuse among adolescents and subsequent diagnoses of cannabinoid hyperemesis syndrome (CHS). Most available literature on this syndrome exists within the adult population and describes benzodiazepines, haloperidol, and topical capsaicin as potentially efficacious in the management of CHS. The objectives of this study were to identify antiemetics and compare their efficacy and safety in the management of pediatric CHS.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>METHODS<\/jats:title>\n          <jats:p>A retrospective review of Penn State Children's Hospital electronic health record was performed to identify patients 18 years or younger who had an emergency department or inpatient encounter, a cannabis hyperemesis\u2013related diagnosis code, and met diagnostic criteria for CHS. Antiemetic efficacy was determined using subjective patient perception of nausea and objective documentation of vomiting. Benzodiazepines, haloperidol, and topical capsaicin were classified as nontraditional antiemetics, whereas all other antiemetics were classified as traditional.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>RESULTS<\/jats:title>\n          <jats:p>Nontraditional antiemetic medications appeared to be more effective in resolving patient symptoms compared with traditional antiemetics. Analysis of all ordered antiemetics demonstrated a gap in partial or full symptom resolution between nontraditional and traditional agents. Reported adverse effects were minimal.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>CONCLUSIONS<\/jats:title>\n          <jats:p>Cannabinoid hyperemesis syndrome is an underrecognized and underdiagnosed condition characterized by cyclic vomiting related to chronic cannabis use. Abstinence from cannabis remains the most effective approach to mitigating morbidity associated with CHS. Medications such as lorazepam or droperidol may have benefit in managing toxidrome symptoms. Traditional antiemetic prescribing remains a key barrier to effective management of pediatric CHS.<\/jats:p>\n        <\/jats:sec>","DOI":"10.5863\/1551-6776-28.3.222","type":"journal-article","created":{"date-parts":[[2023,6,8]],"date-time":"2023-06-08T01:58:53Z","timestamp":1686189533000},"page":"222-227","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of Antiemetics in the Management of Pediatric Cannabinoid Hyperemesis Syndrome"],"prefix":"10.5863","volume":"28","author":[{"given":"Emily","family":"Geraci","sequence":"first","affiliation":[{"name":"Department of Pharmacy, University of Rochester Medical Center\u2013Golisano Children's Hospital, Rochester, NY (EG)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carrie","family":"Cake","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Penn State Children's Hospital, Hershey, PA (CC, KMM)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin M.","family":"Mulieri","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Penn State Children's Hospital, Hershey, PA (CC, KMM)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norman E.","family":"Fenn","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, Manchester University College of Pharmacy and Natural Sciences, Fort Wayne, IN (NEF)"},{"name":"Department of Pharmacy, Parkview Regional Medical Center, Fort Wayne, IN (NEF)"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3883","reference":[{"issue":"4","key":"i2331-348X-28-3-222-b1","series-title":"Curr Drug Abuse Rev","first-page":"241","article-title":"Cannabinoid hyperemesis syndrome","volume":"4","year":"2011","unstructured":"Galli\n              J,\n            \n            \n              Sawaya\n              R,\n            \n            \n              Friedenberg\n              F.\n            \n          \n          Cannabinoid hyperemesis syndrome.\n\t\t\t\t\tCurr Drug Abuse Rev.\n\t\t\t\t\t2011;\n\t\t\t\t\t4(\n\t\t\t\t\t4):\n\t\t\t\t\t241\u2013\n\t\t\t\t\t249."},{"key":"i2331-348X-28-3-222-b2","article-title":"State medical cannabis laws. 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Accessed March 6, 2022","unstructured":"National Institute on Drug Abuse.\n          \n          Monitoring the Future survey: trends in prevalence of various drugs. 2020. Accessed March 6, 2022.\n\t\t\t\t\thttps:\/\/www.drugabuse.gov\/trends-statistics\/monitoring-future\/monitoring-futurestudy-trends-in-prevalence-various-drugs"},{"key":"i2331-348X-28-3-222-b9","series-title":"Gastroenterology","first-page":"1380","article-title":"Rome IV--gastro-duodenal disorders","volume":"150","year":"2016","unstructured":"Stanghellini\n              V,\n            \n            \n              Talley\n              NJ,\n            \n            \n              Chan\n              F,\n            \n          \n          .\n\t\t\t\t\tRome IV--gastro-duodenal disorders.\n\t\t\t\t\tGastroenterology.\n\t\t\t\t\t2016;\n\t\t\t\t\t150:\n\t\t\t\t\t1380\u2013\n\t\t\t\t\t1392."},{"issue":"5","key":"i2331-348X-28-3-222-b10","series-title":"J Emerg Med","first-page":"644","article-title":"Synthetic cannabinoid abuse in adolescents: a case series","volume":"49","year":"2015","unstructured":"Besli\n              G,\n            \n            \n              Ikiz\n              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Psychiatry","first-page":"3614053","article-title":"Successful treatment of suspected cannabinoid hyperemesis syndrome using haloperidol in the outpatient setting","year":"2016","unstructured":"Jones\n              J,\n            \n            \n              Abernathy\n              K.\n            \n          \n          Successful treatment of suspected cannabinoid hyperemesis syndrome using haloperidol in the outpatient setting.\n\t\t\t\t\tCase Rep Psychiatry.\n\t\t\t\t\t2016;\n\t\t\t\t\t3614053."},{"key":"i2331-348X-28-3-222-b13","article-title":"Droperidol injection [package insert]","year":"2021","unstructured":"Droperidol injection [package insert].\n\t\t\t\t\tLake Forest, IL:\n\t\t\t\t\tHospira;\n\t\t\t\t\t2021."},{"key":"i2331-348X-28-3-222-b14","article-title":"Droperidol injection [package insert]","year":"2019","unstructured":"Droperidol injection [package insert].\n\t\t\t\t\tShirley, NY:\n\t\t\t\t\tAmerican Regent;\n\t\t\t\t\t2019."},{"issue":"6","key":"i2331-348X-28-3-222-b15","series-title":"Am J Emerg Med","first-page":"1003.e5","article-title":"Haloperidol for the treatment of cannabinoid hyperemesis syndrome","volume":"31","year":"2013","unstructured":"Hickey\n              J,\n            \n            \n              Witsil\n              J,\n            \n            \n              Mycyck\n              M.\n            \n          \n          Haloperidol for the treatment of cannabinoid hyperemesis syndrome.\n\t\t\t\t\tAm J Emerg Med.\n\t\t\t\t\t2013;\n\t\t\t\t\t31(\n\t\t\t\t\t6):\n\t\t\t\t\t1003.e5\u2013\n\t\t\t\t\te6."},{"key":"i2331-348X-28-3-222-b16","series-title":"Z Gastroenterol","first-page":"1479","article-title":"Hyperemesis and a high water bill","volume":"49","year":"2011","unstructured":"Fleig\n              S,\n            \n            \n              Brunkhorst\n              R.\n            \n          \n          Hyperemesis and a high water bill.\n\t\t\t\t\tZ Gastroenterol.\n\t\t\t\t\t2011;\n\t\t\t\t\t49:\n\t\t\t\t\t1479\u2013\n\t\t\t\t\t1481."},{"key":"i2331-348X-28-3-222-b17","series-title":"J Med Toxicol","first-page":"415","article-title":"Presentations to the emergency department following cannabis use--a multi-centre case series from ten European countries","volume":"11","year":"2015","unstructured":"Dines\n              A,\n            \n            \n              Wood\n              D,\n            \n            \n              Galicia\n              M,\n            \n          \n          .\n\t\t\t\t\tPresentations to the emergency department following cannabis use--a multi-centre case series from ten European countries.\n\t\t\t\t\tJ Med Toxicol.\n\t\t\t\t\t2015;\n\t\t\t\t\t11:\n\t\t\t\t\t415\u2013\n\t\t\t\t\t421."},{"key":"i2331-348X-28-3-222-b18","article-title":"Lorazepam injection [package insert]","year":"2011","unstructured":"Lorazepam injection [package insert].\n\t\t\t\t\tEatontown, NJ:\n\t\t\t\t\tWest-ward Pharmaceuticals;\n\t\t\t\t\t2011."},{"key":"i2331-348X-28-3-222-b19","article-title":"Haloperidol injection [package insert]","year":"2017","unstructured":"Haloperidol injection [package insert].\n\t\t\t\t\tTitusville, NJ:\n\t\t\t\t\tJanssen Pharmaceuticals;\n\t\t\t\t\t2017."},{"key":"i2331-348X-28-3-222-b20","article-title":"Capzasin HP Arthritis Pain Relief Cream (capsaicin) [package insert]","year":"2020","unstructured":"Capzasin HP Arthritis Pain Relief Cream (capsaicin) [package insert].\n\t\t\t\t\tChattanooga, TN:\n\t\t\t\t\tChattem;\n\t\t\t\t\t2020."}],"container-title":["The Journal of Pediatric Pharmacology and Therapeutics"],"original-title":[],"link":[{"URL":"https:\/\/jppt.kglmeridian.com\/view\/journals\/jppt\/28\/3\/article-p222.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/meridian.allenpress.com\/jppt\/article-pdf\/28\/3\/222\/3229064\/i2331-348x-28-3-222.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/jppt.kglmeridian.com\/downloadpdf\/journals\/jppt\/28\/3\/article-p222.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/jppt.kglmeridian.com\/downloadpdf\/journals\/jppt\/28\/3\/article-p222.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T00:48:53Z","timestamp":1747356533000},"score":1,"resource":{"primary":{"URL":"https:\/\/jppt.kglmeridian.com\/view\/journals\/jppt\/28\/3\/article-p222.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023]]},"references-count":20,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.5863\/1551-6776-28.3.222","relation":{},"ISSN":["2331-348X","1551-6776"],"issn-type":[{"value":"2331-348X","type":"electronic"},{"value":"1551-6776","type":"print"}],"subject":[],"published":{"date-parts":[[2023]]}}}