Bath Salts – Synthetic Cathinones Poisoning
Bath Salts – Synthetic Cathinones Poisoning is a topic covered in the 5-Minute Emergency Consult.
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Basics
Description
“Bath salts”:Description
- General term for “designer drugs” containing synthetic cathinones:
- 3,4 methylenedioxypyrovalerone (MDPV) is most common in US
- Also mephedrone, methylone, and many others
- 3,4 methylenedioxypyrovalerone (MDPV) is most common in US
- Sold under numerous names including
- Aura, Bliss, Bolivian Bath, Cloud 9, Ivory Snow, Ivory Wave, Vanilla Sky, White Dove, White Rush
- Labeled “not for human consumption” to evade regulatory control
- Falsely marketed as plant food, insect repellents, “bath salts”
- Aura, Bliss, Bolivian Bath, Cloud 9, Ivory Snow, Ivory Wave, Vanilla Sky, White Dove, White Rush
- Substances may be powders, tablets, or crystals:
- Ranging in color from white, yellow, brown, or gray
- May be ingested, snorted, smoked, injected
- Highly addictive CNS stimulant, often with hallucinogenic properties:
- Many effects similar to cocaine, methamphetamine, or ecstasy
- Severe delirium, psychosis, violence, multiorgan failure, DIC, myocardial infarction, stroke, and deaths have been reported
Epidemiology
Incidence and Prevalence EstimatesEpidemiology
- 1st use in US reported in 2010
- MDPV and mephedrone noted in Europe since 2004
- Called “America's new drug problem” in 2011
- Thousands of cases reported to poison control centers nationwide
- Immediate temporary classification (Fall 2011) as a DEA schedule I controlled substance
- Still available at retail shops or through the internet
Etiology
Etiology
- MDPV is structurally similar to cathinone, an alkaloid derived from the khat plant (chewed socially and abused for centuries in East Africa and Arabian Peninsula)
- Drug chemical formulas change regularly to evade detection, compound identification, and classification as “illegal”
- Principal toxicity derives from effects on dopamine, norepinephrine, and serotonin receptors
- Effects from potential adulterants and contaminants in the drugs remain unknown
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Citation
Rosen, Peter, et al., editors. "Bath Salts – Synthetic Cathinones Poisoning." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307701/all/Bath_Salts_–_Synthetic_Cathinones_Poisoning.
Bath Salts – Synthetic Cathinones Poisoning. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307701/all/Bath_Salts_–_Synthetic_Cathinones_Poisoning. Accessed December 9, 2019.
Bath Salts – Synthetic Cathinones Poisoning. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307701/all/Bath_Salts_–_Synthetic_Cathinones_Poisoning
Bath Salts – Synthetic Cathinones Poisoning [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 December 09]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307701/all/Bath_Salts_–_Synthetic_Cathinones_Poisoning.
* Article titles in AMA citation format should be in sentence-case
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