Cannabinoid Hyperemesis Syndrome (CHS), Ụjọ THC dị elu na ihe oriri sịntetik.¶

Ọ bụ ezie na ahịhịa ahịhịa ọdịnala nwere otu oge ** 2 ruo 4% delta-9-tetrahydrocannabinol (THC), ntinye azụmahịa nke ọgbara ọhụrụ, vape cartridges, wax dabs, pre-rolls, na gummies dị elu na-ebuga ** 70 ruo 95% THC, n'akụkụ hemp-thetics na-enweghị usoro (acetac) THC-P, HHC, Delta-8 THC ) na egbu egbu zuru oke synthetic cannabinoid receptor agonists ("Spice," "K2," MDMB-4en-PINACA, ADB-BUTINACA). Mmụba dị egwu nke ike a emeela ihe mberede ahụike anọ dị iche iche na-ejupụta ngalaba mberede ụlọ ọgwụ kwa ụbọchị: ** Cannabinoid Hyperemesis Syndrome (CHS)* ("scromiting": nhụjuanya, vomiting cyclical projectile na iti mkpu na ndị ọrụ na-adịghị ala ala kwa ụbọchị nke na-ebute ndụ egwu egwu **hypokalemic cardiac arrhythmias) toxicosis na-egbu egbu **, ** nwa na-eto eto mberede na nsị ụmụaka THC gummy ** (nke na-akpata coma na ịda mbà n'obi iku ume na obere ụmụaka), yana ** synthetic cannabinoid ("Spice") neurotoxicity **.

N'ihi na THC na-arụkarị ọrụ dị ka ọgwụ mgbochi ọgbụgbọ na ndị ọrụ oge ụfọdụ, ndị na-eri cannabis na-arịa ọrịa ** Cannabinoid Hyperemesis Syndrome adịkarịghị ekwenye na cannabis bụ ihe kpatara ọgbụgbọ ha na-eme ihe ike, kama na-ese anwụrụ ma ọ bụ vape * karịa * THC iji dozie afọ ha, na-amanye onwe ha n'ime okirikiri physiological dị ize ndụ. Nke ka njọ, ndị ọrịa nọ n'oge hyperemetic nke CHS na-ekpochikarị onwe ha na mmiri ịsa ahụ na-ekpo ọkụ maka awa 6 ruo 12 kwa ụbọchị iji mee ka ndị na-anabata okpomọkụ akpụkpọ ahụ rụọ ọrụ.TRPV1), na-ata ahụhụ siri ike ** ọkụ akpụkpọ anụ na akpịrị ịkpọ nkụ intravascular ngwa ngwa . N'ịmara ka esi amata akara ngosi nke CHS, otu esi eji ** ude capsaicin na-enweghị nchebe kama ịsa mmiri ịsa mmiri, otu esi ewepu oke ụjọ nke THC oriri site na iji usoro oge imeju afọ 11-hydroxy-THC, na mgbe ịkpọ ụgbọ ihe mberede maka ndakpọ electrolyte ma ọ bụ ntinye ụmụaka na-azọpụta ndụ.

Mee nke a ugbu a¶

1. Kpọọ nọmba mberede mpaghara gị (911 na US na Canada, 112 na EU, 999 na UK) ozugbo ma ọ bụrụ na nwatakịrị ma ọ bụ nwata na-eri ihe ọ bụla cannabis gummy, chocolate, ma ọ bụ vape mmanụ, ma ọ bụ ọ bụrụ na onye toro eto na-egosi ọdịdọ, obi mgbu, ịda mbà n'obi, ma ọ bụ enweghị ike idebe mmiri mmiri ruo ihe karịrị awa 12 ruo 24. Lelee anyị. nọmba mberede ndekọ, ma ọ bụ kpọọ Control Poison (1-800-222-1222 na United States). N'adịghị ka ndị okenye, ndị na-eto eto na-eri nri THC nwere ike ịbanye ngwa ngwa n'ime ** omimi coma, ịda mbà n'obi iku ume (kwụsị iku ume), na ọdịdọ.
2. ** Ọ bụrụ na onye na-eji cannabis kwa ụbọchị na-enwe ihe ike, retching ugboro ugboro na oke mgbu afọ na-ebelata naanị site na mmiri ọkụ (Cannabinoid Hyperemesis Syndrome / CHS), Kwụsị THC niile na CBD ozugbo.
3. ** Wepụ onye ọrịa CHS na mmiri ịsa ahụ na-ekpo ọkụ tupu ha ere ọkụ ma ọ bụ daa mbà n'ihi akpịrị ịkpọ nkụ, ma tinye 0.025% na 0.075% Topical Capsaicin ude n'ime afọ kama.*TRPV1 ndị na-anabata okpomọkụ *** dị ka mmiri ịsa ahụ na-esi ísì ụtọ na-emeghị ka ọkụ ọkụ ma ọ bụ ọsụsọ na-akpata akpịrị ịkpọ nkụ.
4. *Chọọ ihe mberede ngalaba IV mmiri mmiri na electrolyte ma ọ bụrụ na onye na-agbọ agbọ nwere mmamịrị gbara ọchịchịrị ma ọ bụ na-anọghị ya, mgbaka akwara, obi mgbawa, mgbagwoju anya, ma ọ bụ vomits ọbara.
5. ** Ọ bụrụ na mmadụ na-enwe egwu egwu na-atụ egwu, obi na-agba ọsọ, ma ọ bụ paranoia mgbe ọ na-eri nri THC iwu kwadoro (na ume iku ume na enweghị kemịkal sịntetik), mee ka ha gaa n'ọnụ ụlọ dị jụụ ma mee ka obi sie ha ike na ọnụ ọgụgụ kasị elu ga-agafe. Na-eduzi igbe iku ume ngwa ngwa, na-enye mmiri oyi, ma mee ka ha tachaa ma ọ bụ nupụta ** ose oji zuru ezu ** ma ọ bụ peel lemon (beta-caryophyllene na limonene terpenes na-enyere aka n'ala na-atụgharị uche nghọta).
6. ** Na-emeso mmeghachi omume ọ bụla na "ose," "K2," mmanụ-vape n'okporo ámá, ma ọ bụ ọdụ gas "THC-P / HHC / Mushroom" gummies dị ka nsị ọgwụ na-eyi ndụ egwu.*

Ọsọ ọsọ ọsọ: Ịmata nke ihe mberede Cannabinoid na-eme¶

flowchart TD
    A["Cannabis ma ọ bụ Cannabinoid Mberede"] --> B{"Kedu ụkpụrụ ụlọ ọgwụ dabara na onye ọrịa?"}
    B -->|Young Child / Toddler Ate THC Edible| C["Mberede ụmụaka: Kpọọ 911 / Njikwa nsi Ugbu a - Nnukwu ihe ize ndụ nke Coma & Kwụsị iku ume"]
    B -->|Chronic Daily User: Non-Stop Vomiting, Belly Pain, Compulsive Hot Showers| D["Cannabinoid Hyperemesis Syndrome - CHS"]
    B -->|Ate Too Much THC Edible / High-Dose Dab: Racing Heart, Terror, Time Distortion| E["Nnukwu ike dị elu THC ụjọ / ịṅụbiga mmanya ókè"]
    B -->|Used Synthetic Spice, K2, Street Vape, or Unknown Gas-Station Analog| F["Nsí SYNTETIC: Kpọọ 911 ozugbo - Ihe ize ndụ nke Ọdụdọ, Mwakpo Obi, & Psychosis"]
    D --> G["1. Kwụsị Cannabis niile ozugbo 2. Tinye Topical Capsaicin 0.075% n'ime afọ 3. Gaa na ER maka mmiri mmiri IV, Potassium, & Haloperidol/Droperidol ma ọ bụrụ na ọgbụgbọ na-adịgide."]
    E --> H["1. Ụlọ dị jụụ Dim 2. Mesie 11-OH-THC ọnụ ọnụ na 2 ruo 4 Hours 3. Ịkụ ume ngwa ngwa & SIP Water 4. Kpọọ 911 Naanị ma ọ bụrụ na Mgbu obi, Syncope, ma ọ bụ Psychosis na-adịghị ize ndụ"]

Ntụle ahụike nke ihe mberede Cannabinoid anọ¶

Nkebi 1: Cannabinoid Hyperemesis Syndrome (CHS) na "Scromiting"¶

Ebu ụzọ kọwaa na akwụkwọ ahụike na 2004 wee hazie ya na ** Rome IV Diagnostic Criteria for Functional Gastrointestinal Disorders , ** Cannabinoid Hyperemesis Syndrome (CHS) na-emetụta ndị na-eji ngwaahịa cannabis dị arọ, na-adịghị ala ala (gụnyere cannabis ọgwụ, mgbatị ntụrụndụ, Delta-8 THC, yana CBD yana ọgwụ dị elu).

1. Usoro ọgwụgwọ atọ nke CHS¶

1. ** Usoro Prodromal (ọnwa ruo ọtụtụ afọ):** Onye ahụ na-amalite ọgbụgbọ n'isi ụtụtụ, mmetụta utoojoo ma ọ bụ "urukurubụba" n'ime afọ, egwu ịgba agbọ, na ahụ erughị ala afọ. ** Ọnyà na-egbu egbu: *** N'ihi na iku ume THC na-ebute ụbụrụ etiti nwa oge CB1 Ndị na-anabata ya na-ekpuchi ọgbụgbọ maka nkeji 30, onye ahụ na-amalite iteta ma na-aṅụ mmanya ma ọ bụ na-aṅụ sịga ozugbo kwa ụtụtụ iji kwụsị ọgbụgbọ, na-abawanye ibu cannabinoid ha kwa ụbọchị ruo mgbe ndị na-anabata eriri afọ ha na-abanye na nsogbu.
2. ** Usoro Hyperemetic (Oké Mberede: awa 24 ruo 10+ ụbọchị):**
   • Mberede na mberede nke ** na-adịghị agwụ agwụ, ọgbụgbọ na-adịghị ike na ọgbụgbọ (mgbe 5 ruo 20 ugboro n'otu awa) na-esonyere ya na ụda olu na-egbu mgbu epigastric ("scromiting").
   • Pathognomonic Hot-water ịsa ahụ: Ihe karịrị ** pasent 90 nke ndị ọrịa CHS ** chọpụta na iguzo n'okpuru mmiri ịsa ahụ na-ekpo ọkụ ma ọ bụ ịnọdụ n'otu ebe ịsa ahụ na-esi esi mmiri ozugbo na-ebelata ihe mgbu afọ na ọgbụgbọ, naanị maka ọgbụgbọ na-alọghachi n'ime nkeji ole na ole ha si na mmiri pụta. Ndị ọrịa na-ekpochapụ igwe ọkụ nke ụlọ ha ọtụtụ ugboro n'ụbọchị ma ọ bụ lelee ọnụ ụlọ nkwari akụ naanị maka mmiri ọkụ na-aga n'ihu.
3. ** Usoro mgbake (izu ruo ọnwa mgbe 100% kwụsịtụrụ):** Ọgbụgbọ na-akwụsị n'ime 2 ruo ụbọchị iri ** nke ịkwụsị kpamkpam cannabinoids niile, na agụụ nkịtị na ịdị arọ na-alaghachi n'ime izu ole na ole. CB1 na TRPV1 nrụpụta nrụpụta. ** Agbanyeghị, ọ bụrụ na onye ahụ na-eji cannabis ọbụlagodi otu ugboro n'oge mgbake, usoro hyperemetic zuru oke na-alọghachi ugboro ugboro n'ime awa ma ọ bụ ụbọchị.

2. Gịnị kpatara ịsa ahụ na-ekpo ọkụ na-arụ ọrụ (na ihe kpatara Topical Capsaicin Cream bụ ihe nnọchi ahụike dị mma)¶

N'ime hypothalamus nke mmadụ (nke na-achịkwa okpomọkụ ahụ) na akwara niile nke eriri afọ, **CB1 ndị na-anabata cannabinoid na-anọdụ ala n'akụkụ TRPV1 (Vanilloid 1) ndị na-anabata ihe na-anabata ya , ọwa ion ziri ezi nke ** okpomọkụ na-adịghị mma na-arụ ọrụ (> 43 degrees Celsius / 109 degrees Fahrenheit) na chili-ose capsaicin.

• Mgbe oke ọgwụ THC na-adịghị ala ala kwụsịrị CB1 ndị na-anabata ya na ahụ kpọnwụrụ akpọnwụ ime afọ (gastroparesis), ihe mgbaàmà mgbu nke eriri afọ na-aga haywire.
• Iguzo n'okpuru mmiri mmiri 45-degree-Celsius (113-degree-Fahrenheit) na-eju akpụkpọ ahụ. TRPV1 irighiri akwara nwere akara okpomoku, na-agbapụ ọbara site na arịa eriri afọ splanchnic gaa n'akpụkpọ ahụ ("cutaneous steal Syndrome") na gafere etiti ọgbụgbọ nke ụbụrụ.
• ** Otu esi eji Topical Capsaicin ude n'ụlọ ma ọ bụ na triage kama ịsa mmiri ọkụ:**
  1. Ịzụta ọkọlọtọ n'elu-na-counter 0.025%, 0.075%, ma ọ bụ 0.1% Capsaicin ude (erere n'ụlọ ahịa ọgwụ ọ bụla maka ọrịa ogbu na nkwonkwo / akwara mgbu).
  2. Iji gloves enwere ike iwepu (ma ọ bụ na-asa aka nke ọma na ncha efere ma emesịa), tinye ude capsaicin nke dị obere ** dị mkpa n'ofe akpụkpọ afọ (afọ) ma ọ bụ azụ nke ogwe aka elu ** ihe ruru ugboro atọ kwa ụbọchị.
  3. Ejila ude capsaicin ozugbo ị pụtachara na ịsa ahụ na-ekpo ọkụ (chere ruo mgbe akpụkpọ ahụ jụrụ oyi ka ọ na-ekpo ọkụ, ma ọ bụ na ọkụ ahụ ga-esiwanye ike), ma chebe ya pụọ ​​​​na anya, ọnụ, gbajiri agbaji na akụkụ ahụ. (Ọ bụrụ na capsaicin na-ere ọkụ nke ukwuu, hichapụ ya na ** esi nri mmanụ nri ma ọ bụ mmiri ara oyi, ọ bụghị mmiri; lee Capsaicin ose chili na-ere ọkụ n'anya, akpụkpọ, na aka.)
  4. N'ime ** 20 ruo 45 nkeji ***, mmetụta ọkụ nke capsaicin na-eme ka afọ ime TRPV1 ndị na-anabata ya ma na-agbaji ọgbụgbọ / mgbu ahụ na-emefusịghị mmiri ahụ n'ime mmiri ọkụ.

3. Ọkọlọtọ na-acha ọbara ọbara nke Ngalaba Mberede na ihe kpatara ọgwụ ọgbụgbọ ọkọlọtọ na-ada ada¶

Na ngalaba mberede ụlọ ọgwụ, ọkọlọtọ serotonin 5-HT3 Ndị na-emegide dị ka ondansetron (Zofran) ma ọ bụ promethazine bụ ndị amachaghị arụ ọrụ megide CHS siri ike n'ihi na ọ bụ dopamine na-ebute vomiting.TRPV1/CB1 dysregulation kama serotonin. Nnwale ụlọ ọgwụ na-ahaziri ahazi (dị ka HaVOC Trial) egosila na obere dose ** IV haloperidol (0.05 mg/kg ma ọ bụ 2.5 to 5 mg) ma ọ bụ IV droperidol *, jikọtara ya na ** 1 ruo 2 lita nke mmiri mmiri kristal IV, ngbanwe potassium/magnesium, na abdominal capsaicin, na-akwụsị ịgba agbọ CHS ngwa ngwa ma gbochie nnabata ụlọ ọgwụ.

Gaa na ngalaba ihe mberede ozugbo ma ọ bụrụ na onye na-agbọ agbọ nwere ọkọlọtọ uhie ndị a:

• Enweghị ike idowe obere sips nke ngwọta electrolyte ọnụ maka ** karịa awa 12 ruo 18 ***.
• ** Ihe ịrịba ama nke Hypokalemia & Oké akpịrị ịkpọ nkụ:** Mkpụkpọ akwara ma ọ bụ adịghị ike n'ụkwụ, ntugharị ma ọ bụ ịgba ọsọ obi, oke isi ọwụwa ma ọ bụ nkụda mmụọ mgbe ị na-ebili ọtọ, anya dara nkụ, ma ọ bụ ** enweghị mmamịrị ruo awa 8+ (ma ọ bụ mmamịrị aja aja)**.
• ** Na-agbapụta ọbara ọbara na-acha ọbara ọbara ma ọ bụ "kọfị-ala" ihe gbara ọchịchịrị ** (Mallory-Weiss esophageal anya mmiri site na retching ime ihe ike) ma ọ bụ mgbawa mberede ** obi ma ọ bụ olu mgbu na ikuku ikuku n'okpuru akpụkpọ ahụ ** (** ọrịa Boerhaave **: mgbawa esophageal na-egbu egbu).
• Akụkụ ahụ siri ike, dị ka afọ, nnukwu ahụ ọkụ, ma ọ bụ ihe mgbu dị n'akụkụ aka nri-ala n'akụkụ anọ: Ya adịla mgbe ị ga-eche na mgbu afọ na onye na-eji cannabis bụ "naanị CHS" ruo mgbe ihe mberede ịwa ahụ na-eyi ndụ egwu (appendicitis, pancreatitis, mgbochi afọ, afọ ime ectopic, ma ọ bụ perforation gallbladder) ka dọkịta ewepụla ya.

Nkebi 2: Nnukwu ike dị elu THC Mwakpo ụjọ na-eri nri na ịṅụbiga mmanya ókè¶

Ihe na-ebutekarị nnukwu nleta ụlọ mberede cannabis n'etiti ndị ọrụ oge ụfọdụ, ndị njem nlegharị anya na ndị toro eto bụ ** ọnụ THC oriri n'ụbiga mmanya ókè ("greening out")**.

1. Gịnị mere oriri kụrụ nke ukwuu ike na mgbe e mesịrị karịa ise siga: The 11-Hydroxy-THC ọnyà¶

+-------------------------------------------------------------------------+
|        INHALED THC vs. ORAL EDIBLE THC PHARMACOKINETIC TIMELINE         |
|                                                                         |
|  INHALED (Smoking / Vaping):                                            |
|  - Onset: 2 to 10 minutes  |  Peak: 15 to 30 minutes                    |
|  - Duration: 2 to 4 hours  |  Active Molecule: Mostly Delta-9-THC       |
|                                                                         |
|  ORAL EDIBLES (Gummies, Chocolates, Baked Goods, Tinctures):            |
|  - Onset Delay: 45 to 120 minutes (up to 3 hours after a fatty meal)    |
|  - Peak Intensity: 2 to 4 hours after ingestion                         |
|  - Total Duration: 6 to 12+ hours (residual grogginess up to 24 hours)  |
|  - Active Molecule: Liver Cytochrome P450 (CYP2C9) converts Delta-9-THC |
|    into 11-HYDROXY-THC, a metabolite that crosses the blood-brain       |
|    barrier far more rapidly and produces intense psychoactive effects.  |
+-------------------------------------------------------------------------+

N'ihi na oriri na-ewe nkeji 60 ruo 120 ** iji gbarie nri, ndị ọrụ na-amaghị ihe na-eri nri. 10 mg ma ọ bụ 25 mg gummy, enwechaghị ihe ọ bụla na nkeji 45, ma rie gummies abụọ ma ọ bụ atọ ọzọ ozugbo tupu ọgwụ mbụ abanye n'imeju ha (** dose stacking**). Mgbe awa abụọ gachara, 50 to 100 mg nke 11-hydroxy-THC idei mmiri na ụbụrụ ha n'out oge.

2. Mwepụ nke ụlọ site na nzọụkwụ maka nnukwu ọgụ ụjọ THC¶

Mgbe mmadụ riri ahụ nri ma ọ bụ itinye uche nke THC iwu kwadoro (ma nweekwa ihe mgbu obi, ọdịdọ, ma ọ bụ ikpughe ọgwụ sịntetik), ha na-enwetakarị ** sinus tachycardia (110 to 145 beats per minute), orthostatic hypotension (na-eche ka ha ga-apụ mgbe ha guzoro ọtọ), ịgbasa oge (nkeji 5 dị ka awa 2), na nkwenye siri ike nke somatic na obi ha na-akwụsị ma ọ bụ na ha echefuola ka ha na-eku ume ozugbo ***.

1. ** Mepụta ebe nsọ ihe mkpali dị ala:**
   • Duru onye ahụ gaa n'ọnụ ụlọ ihi ụra ma ọ bụ ihe ndina dị jụụ, na-enwu ọkụ. Gbanyụọ egwu na-ada ụda, ihuenyo telivishọn na-egbukepụ egbukepụ, na ọkụ fluorescent dị n'elu, ma rịọ ndị ọzọ ka ha pụọ ​​​​n'ime ụlọ ahụ naanị ** otu olu dị jụụ, ntụkwasị obi *** na-ekwu.
2. ** Wepụta mmesi obi ike na ntinye oge:**
   • Na-ekwu okwu n'olu dị nwayọọ, na-ekpo ọkụ, nke eziokwu: * "Ị na-eri nri THC siri ike na [Oge]. Ihe ị na-eche ugbu a bụ 11-hydroxy-THC peaking na usoro gị. Obi gị ngwa ngwa bụ ihe na-eme ka adrenaline reflex si THC, ọ bụghị obi mgbawa. Ọ dịghị onye ọ bụla nwụrụ site na psychoactive ọnụ ọgụgụ nke a eke THC nri ugbu a. Mgbe nkeji iri atọ gawa ebe a, imeju gị na-ehichapụ ya, ahụ ga-adịkwa gị jụụ."*
3. Dịna ala ma ọ bụ nọdụ ala iji gbochie mmekọrịta (ịda mba):
   • THC na-ebute vasodilation mpụta (ọbara na-agbakọta n'ụkwụ), nke na-ebute mbelata ọbara mgbali na mberede na nkụda mmụọ ma ọ bụrụ na onye ahụ biliri ngwa ngwa ịga ije na ụlọ ịsa ahụ. Debe ha ka ha dinara ala ma ọ bụ tinye n'elu ohiri isi na-ebuli ụkwụ ha elu, ma duru ha anụ ahụ ma ọ bụrụ na ha ga-eguzorịrị iji mposi.
4. ** Grounding Sensory na Black Peppercorn / Lemon Technique:**
   • Mee ka ha debe ákwà ịsa ahụ dị jụụ, nke dị nhịahụ n'egedege ihu ha na azụ n'olu ha ** (na-eme ka ụbụrụ mammalian dive reflex na akwara vagus iji jiri nwayọọ nwayọọ belata ọnụọgụ obi).
   • Mmiri ose ojii zuru oke ma ọ bụ bee lemon ọhụrụ: Ọ bụrụ na ha na-amụ anya ma nwee ike ilo nke ọma, ka ha rie ose oji gbawara ọhụrụ ma ọ bụ rie ** 2 ruo 3 nnukwu ose ojii zuru oke**, ma ọ bụ fechaa bee lemon ma rie mmiri lemon. ose ojii nwere nnukwu ọkwa nke beta-caryophyllene, sesquiterpene nri nke na-eme dị ka nhọrọ **CB2 agonist receptor agonist na allosteric modulator na-adịghị mma ** egosipụtara na nyocha ụlọ ọgwụ cannabinoid iji mee ka nchekasị THC kpata ya, ebe citrus ** limonene ** na-ebelata oke THC paranoia.
   • Ji nwayọọ nwayọọ 4-6 iku ume Vagal: Kụziere ha ka ha kukuo nwayọọ nwayọọ site na imi ruo ** sekọnd 4** wee kupụkwa nwayọọ nwayọọ site na egbugbere ọnụ e mechiri emechi maka ** sekọnd isii (ịgbatị iku ume ahụ na-akpali ụda vagal parasympathetic ma na-ebelata ọ̀tụ̀tụ̀ obi).
5. ** Ihe agaghị eme n'oge egwu THC: ***
   • Mgbe ọ bụla enyela caffeine, ihe ọṅụṅụ ike, ma ọ bụ mmanya *** (caffeine na-akawanye njọ tachycardia na ụjọ; mmanya na-aba n'anya na-abawanye mmịnye eriri afọ nke THC).
   • ** Amanyela ha n'ime mmiri ịsa ahụ oyi mgbe ha guzoro ** (na-ebute vasoconstriction mberede ma ọ bụ mmerụ ahụ na-adaba na isi).

Nkebi 3: Mberede ụmụaka THC Gummy Ingestion (Mgbapụta Dị Mkpa)¶

A na-akwakọbakarị chịngọm THC azumahia, mmanya chọkọletị na swiiti nerd na-acha ọkụ n'ụdị mylar wrappers na-adị ka swiiti nnukwu ụlọ ahịa, yana otu ngwugwu nwere ** 100 ruo 1,000 milligrams THC** (10 ruo 100 okenye doses).

• ** Gịnị kpatara nri THC ji na-eyi ndụ egwu nye ndị na-eto eto na ụmụaka:** N'ime okenye ruru kilogram 75 (165 pound), 50 mg nke THC na-ebute ọgụ ụjọ na-adịghị mma. N'ime nwata na-eru ** kilogram 12 (paụnd 26)**, na-ejide ma na-eri obere chịngọm nwere. 100 to 300 mg THC na-enye oke ọgwụ na-egbu egbu (10 to 25 mg/kg).
• ** Ọganihu ụlọ ọgwụ ụmụaka (awa 1 ruo 6 mgbe ịrichara nri):**
  • Ihe ịrịba ama mbụ (nkeji 30 ruo 90): Ije ije na-adịghị akwụsị akwụsị (ataxia), anya gbasapụrụ enyo, ịkwa emo ma ọ bụ mkpu ákwá na-enweghị ntụsara ahụ na mberede, okwu na-adịghị mma, na ịma jijiji ahụ.
  • Ihe ịrịba ama siri ike (awa 1 ruo 4): Ọganihu ngwa ngwa ruo ** nnukwu ike ọgwụgwụ, enweghị ike iteta na mkpali na-egbu mgbu (coma), iku ume ngwa ngwa ma ọ bụ nke na-emighị emeri (bradypnea / apnea na-achọ endotracheal intubation), ịdaba na okpomọkụ nke ahụ (hypothermia), na njide tonic-clonic zuru oke.
• ** Ihe omume ozugbo maka ndị nne na nna na ndị nlekọta: ***
  1. Echerela ka mgbaàmà pụta ìhè. N'ihi na ọnụ ọnụ na-ewe awa 1 ruo 2 iji banye, nwatakịrị nke na-ele anya nke ọma 20 nkeji mgbe o richara THC gummy nwere ike ịkwụsị iku ume n'ihe ndina ha ka awa abụọ gachara.
  2. ** Kpọọ 911/112/999 ma ọ bụ njikwa nsi (1-800-222-1222 na US) ozugbo** were nwa ahụ na ihe mkpuchi swiiti ahụ gaa na ngalaba mberede ụlọ ọgwụ kacha nso.
  3. Bụrụ 100% eziokwu nye ndị ọrụ ahụike na ndị dọkịta ER gbasara ihe nwa ahụ riri. Ịgwa dọkịta ozugbo na ọ bụ ihe oriri THC na-azọpụta nwa ahụ site n'ọkpụkpụ azụ azụ (nkụkụ lumbar), isi CT radieshon, na ọgwụ nje na-adịghị mkpa ebe ndị dọkịta na-achọ ihe na-akpata coma mberede.

Nkebi 4: Cannabinoids sịntetik ("Spice," "K2") na Hemp Analogs anaghị achịkwa.¶

Ekwela ka emegharịla cannabis ahịhịa sitere n'okike na ** Synthetic Cannabinoid Receptor Agonists (SCRAs)** erere dị ka incense herbal (**"Spice," "K2," "Black Mamba," "Scooby Snax"), mmiri mmiri vape okporo ụzọ, ma ọ bụ ikike dị elu semi-synthetic hemp derivatives (*-PHC): T-

1. ** Neurotoxicity Agonist zuru oke ("Spice" / "K2"):** Natural Delta-9-THC bụ naanị ** agonist akụkụ ** na ụbụrụ. CB1 anabata, pụtara ya physiological mmetụta akụrisị a eke n'uko. cannabinoids sịntetik nke ụlọ nyocha emere n'ụzọ iwu na-akwadoghị (dịka MDMB-4en-PINACA, ADB-BUTINACA, na 5F-MDMB-PICA) bụ ** agonists zuru oke nwere ike 20 ruo 800 nke THC *. Ha na-akpalite ** nnukwu ọdịdọ na-egbu egbu, hyperthermia dị oke njọ, rhabdomyolysis (nkụda akwara na-emebi akụrụ), akwara akwara na-akpata nkụchi obi na ndị nọ n'afọ iri na ụma, na ihe ike paranoid psychosis.
2. ** Vitamin E Acetate & Ketene Gas sitere na THC-O Vape Cartridges: ** kpo oku ** THC-O-acetate ** ma ọ bụ mmanụ vape na-ezighi ezi bee na Vitamin E acetate na pen pen na-ekpo ọkụ na-agbawa otu acetate n'ime gas ketene.CH2=C=O***, nsi akpa ume na-egbu egbu nke metụtara phosgene nke na-ebute EVALI (E-cigare ma ọ bụ Vaping Use-Associated Lung Injury), oyi oyi na-egbu egbu, na nnukwu iku ume.
3. Brodifacoum ("Superwarfarin" Rat Poison) ịkwa iko: ** Ọtụtụ ntiwapụ ahụike ọha na eze na-enyocha site na CDC gụnyere n'okporo ámá synthetic synthetic cannabinoids fesa na brodifacoum (nsi oke na-eme ogologo oge) iji gbatịa elu, na-eme ka ndị ọrịa na-agbapụta ozugbo site na goms, imi, afo, ọbara ọbara na-acha uhie uhie na ọnwa ole na ole. oke dose ** Vitamin K1 ndenye ọgwụ (phytonadione) ọgwụgwọ.

Nkebi nke 5: Ịlanarị Mwepụ Cannabis dị egwu na Nkwụghachi ụra nke Abụọ Mgbe Ọ kwụsịrị maka CHS¶

Maka ndị ọrịa achọpụtara na ** Cannabinoid Hyperemesis Syndrome ** ma ọ bụ ịdabere n'ike dị elu kwa ụbọchị.70% to 90% THC wax / vape carts), otu ihe mgbochi kachasị sie ike iji nọrọ nke ọma bụ ịlanarị ** mbụ 7 ruo ụbọchị 14 nke nnukwu mwepu cannabis ** na-alaghachighị azụ iji kwụsị ahụ erughị ala ahụ.

1. Usoro iheomume nke nnukwu ike ike THC ndọrọ ego¶

Achọpụtara na DSM-5-TR, Cannabis Withdrawal Syndrome (CWS) na-amalite n'ime awa 24 ruo 48 nke ịkwụsị iji ụbọchị, ọnụ ọgụgụ dị elu n'etiti ** Ụbọchị 2 na 6 **, ma na-agbadata n'ime ** 2 ruo 3 izu ** (n'agbanyeghị REM rebound nrọ nwere ike ịdịru ruo ụbọchị 45):

• ** Mweghachi nke eriri afọ:** Ọnwụ nri, mgbaka afọ dị nro, na ịma jijiji nke ụtụtụ. (Ọkachamma, ozugbo ị gafere elekere 48 ruo 72 na-enweghị THC, cyclic "scromiting" nke CHS na-akwụsị ma jiri nwayọ nwayọ dochie ya.)
• ** N'ihi na THC na-adịghị ala ala na-egbochi ụra ụra ọsọ ọsọ (REM), ịkwụsị na-akpalite nnukwu ụra ụra ** REM: ehighị ụra nke ọma nke mbụ na-esote nke pụtara ìhè, jọgburu onwe ya, ma ọ bụ nro na-enweghị atụ ma na-emeju ** ọsụsọ abalị ** na-etinye akwa akwa.
• ** Mgbanwe nke Onwe & Ọnọdụ: *** Enweghị izu ike, mgbakasị ahụ, iwe mberede, oyi, ịma jijiji aka dị nro, na isi ọwụwa.

2. Nchekwa, nlekọta nkasi obi na-abụghị cannabinoid n'oge nhazigharị CHS ụbọchị 14¶

1. ** Mweghachi mmiri nke ọnụ na ọganihu BRAT-Plus: ***
   • N'ime awa 48 nke mbụ mgbe ihe omume CHS kwụsịrị, sụọ ** salts rehydration oral chilled (WHO ORS, Pedialyte, ma ọ bụ Liquid I.V.), efere ọkpụkpụ na akwụkwọ nri, na mmanya na-egbu egbu na ** 15 milliliters (1 tablespoon) kwa nkeji 10 ọ bụla kama ịkwanye otu iko zuru oke nke mmiri na-eme ka mmiri na-eme ka ọ gbatịa.
   • Ozugbo mmiri na-agbada ruo awa 12, webata nri na-adịghị mma, nke nwere obere abụba (** unere, osikapa ọcha, apụl, toast akọrọ, crackers saltine, na ginger tii**). Zere nri nwere nnukwu abụba ma ọ bụ e ghere eghe maka izu mbụ, n'ihi na abụba erimeri na-ebelata ịwụfu afọ.

2. ** Ijikwa ọsụsọ abalị na ehighị ụra nke ọma na-alaghachighị:**

   • Mee ka ime ụlọ dị jụụ (** 16 ruo 18 degrees Celsius / 60 ruo 65 degrees Fahrenheit **), akwa akwa akwa ume ume, ma debe uwe mwụda akọrọ n'akụkụ akwa.
   • Jụọ dọkịta gị gbasara ụra na-adịghị adị mkpụmkpụ ma ọ bụ nkwado ọgbụgbọ (dị ka ** melatonin 1 ruo 3 mg *, ** hydroxyzine , ** doxylamine, ma ọ bụ ** promethazine / prochlorperazine ** suppositories) n'oge Days 1 ruo 7. ** Ejila mmanụ CBD, hemp vapeHS ma ọ bụ Delta na-agbadata phytocannabinoids na-adịghị egbu egbu na-emekọ ihe na enteric TRPV1 na CB1 ndị na-anabata ya ma na-akpalite hyperemesis.

3. (Ọ bụrụ na gị ma ọ bụ onye ị hụrụ n'anya na-agbasi mbọ ike na-adabere na ike cannabis kwa ụbọchị, iji ọgwụ sịntetik, ma ọ bụ ụlọ ọgwụ CHS na-aga n'ihu, lee. Iji ihe na ọgwụ riri ahụ: ntuziaka enyemaka mberede na Ịkwado onye òtù ezinụlọ na-eri ahụ. Anyị na-akwado ka ị nweta nkuzi enyemaka izizi sitere na Red Cross, St John Ambulance, ma ọ bụ onye na-eweta mpaghara.)*

Ajụjụ a na-ajụkarị¶

enyochara isi mmalite¶

• ** American College of Gastroenterology (ACG) na Rome Foundation: ** Rome IV Criteria Diagnostic Criteria na Clinical Practice Guidelines for Cannabinoid Hyperemesis Syndrome (CHS)* (Aphases nke CHS, mgbochi mmiri na-ekpo ọkụ na-asa ahụ pathophysiology, na njedebe nkwụsị zuru ezu).
• ** American College of Emergency Physicians (ACEP) & Annals of Emergency Medicine (HaVOC Randomized Trial):** * Intravenous Haloperidol / Droperidol na Topical Capsaicin (0.075% ka 0.1%) vs. Ondansetron na Ngalaba Mberede nke Cannabinoid Hyperemesis Syndrome*.
• ** Centers for Disease Control and Prevention (CDC) na American Association of Poison Control Centre (AAPCC, United States):**
• ** National Institute on Drug Abuse (NIDA / NIH, United States) & World Health Organisation (WHO):** Pharmacokinetics nke ọnụ 11-hydroxy-THC vs. ikuru ume Delta-9-THC, na nnukwu toxicology nke Full-Agonist Synthetic Cannabinoid Receptor Agonists (* Spice / K2*).
• ** Akwụkwọ akụkọ Britain nke Pharmacology (Russo, E. B.): *** Taming THC: Cannabis Synergy na Phytocannabinoid-Terpenoid Entourage Effects * (Pharmacology nke beta-caryophyllene na limonene na-ebelata oke nchegbu THC).

Ntuziaka emetụtara¶

• Iji ihe na ọgwụ riri ahụ: ntuziaka enyemaka mberede
• Ịkwado onye òtù ezinụlọ na-eri ahụ
• Mwakpo ụjọ na oke nchegbu
• Nsogbu ahụike uche na ihe mberede igbu onwe
• Nsi nri, nnukwu gastroenteritis, na akpịrị ịkpọ nkụ
• Capsaicin ose chili na-ere ọkụ n'anya, akpụkpọ, na aka
• Enyemaka mbụ na-egbu egbu
• Nọmba mberede