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    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”:
    • General term for “designer drugs” containing synthetic cathinones:
      • 3,4 methylenedioxypyrovalerone (MDPV) is most common in US
        • Also mephedrone, methylone, and many others
    • 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”
    • 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 Estimates
    • 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

    • 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

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    TY - ELEC T1 - Bath Salts – Synthetic Cathinones Poisoning ID - 307701 ED - Barkin,Adam Z, ED - Barkin,Roger M, ED - Hayden,Stephen R, ED - Rosen,Peter, ED - Schaider,Jeffrey J, ED - Shayne,Philip, ED - Wolfe,Richard E, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307701/all/Bath_Salts_–_Synthetic_Cathinones_Poisoning PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -