Cannabinoid Hyperemesis Syndrome (CHS), Te Manawa Nui o te THC Panic, me nga Kai Hangaia.¶

Ahakoa he 2 ki te 4 ōrau delta-9-tetrahydrocannabinol (THC) i mua i te rongoa otaota tuku iho, ko nga kakano arumoni hou, nga kaata vape, te wax dabs, te whakauru i mua i nga pukapuka, me nga gummies nui te tuku 70 ki te 95 ōrau THC, i te taha o te hemp-ahua mai i te hemp semi-synthetics (**THC-O-a8) (THC-O-a8) (THC-O-a8) whakamate tino waihanga cannabinoid receptor agonists ("Spice," "K2," MDMB-4en-PINACA, ADB-BUTINACA ). Ko tenei pikinga nui o te kaha kua hanga e wha nga ohorere hauora motuhake e whakakii ana inaianei i nga tari whawhati tata o te hohipera i ia ra: ** Cannabinoid Hyperemesis Syndrome (CHS) ("scromiting": te mamae, te ruaki o te kaupapa porohita me te hamama i roto i nga kaiwhakamahi o ia ra e whakaohooho ana i te ora hypokalemic cardiac arrhythmias teitei), me te THC ko te whatukuhu paitini, te paheketanga o te ngakau, THC psychosis, te kohungahunga ohorere me te tamaiti THC kawa kapia ** (e pa ana ki te koma me te pouri o te manawa i roto i nga tamariki iti), me te ** cannabinoid waihanga ("Spice") neurotoxicity.

Na te mea ko te THC te tikanga he puhui anti-nausea i roto i nga kaiwhakamahi i etahi wa, ko nga kaihoko cannabis mau tonu e mate ana i te Cannabinoid Hyperemesis Syndrome he uaua ki te whakapono ko te cannabis te take o to ratou ruaki tutu, engari ka paowa, ka vape ranei * ake * THC ki te whakatau i o ratau puku, ka mau i a ratau i roto i te huringa tinana kino. Ko te mea kino atu, ko nga turoro i roto i te wahanga hyperemetic o CHS he maha nga wa ka kati ratou i roto i nga ua wera-wera mo te 6 ki te 12 haora ia ra ki te whakahohe i nga kaiwhakawhiwhi wera kiri (TRPV1), e mamae nui ana ** te wera wera o te kiri me te paheketanga tere o roto i te toto**. Ma te mohio me pehea te mohio ki nga tohu tohu o te CHS, me pehea te whakamahi i te topical capsaicin cream ma te haumaru hei utu mo te ua koropupuu, me pehea te whakaheke i te whakaeke ohorere THC kai ma te whakamahi i te hepatic hepatic 11-hydroxy-THC timeline, me te wa e waea ai i te waka tūroro mo te hinganga electrolyte, te horomanga tamariki ranei ka ora.

Mahia tenei inaianei¶

1. Waea atu ki to nama whawhati tata (911 i te US me Kanata, 112 i roto i te EU, 999 i te UK) mena ka kai tetahi tamaiti iti, kohungahunga ranei i ANY cannabis gummy, tiakarete, hinu vape ranei, ki te kitea ranei e tetahi pakeke te maru, te mamae o te uma, te ngenge, te kore ranei e kaha ki te pupuri i te wai mo te neke atu i te 12 ki te 24 haora. Tirohia ta matou tau ohorere whaiaronga, waea atu ranei ki te Mana Paihana (1-800-222-1222 i roto i te United States). Kaore i rite ki nga pakeke, ko nga kohungahunga e kai ana i nga kai THC ka tere te paheke ki roto i te koma hohonu, te pouri o te manawa (kua mutu te manawa), me te maru.
2. Mena kei te raru tetahi kaiwhakamahi tarukino i ia ra, i te mamae tonu o te puku me te mamae nui o te puku na te ua wera anake (Cannabinoid Hyperemesis Syndrome / CHS), KATOA TONU KATOA THC ME CBD. Kaua e kai paipa, vape, pani, tango kai ranei hei "whakamarie i te nausea": ia horopeta o te huringa cannabinoid ka roa te ruaki.
3. Tangohia tetahi turoro CHS mai i nga ua wera i mua i te wera o te kiri, ka ngenge ranei i te matewai, ka pania ki runga i te kaute 0.025% ki te 0.075% Topical Capsaicin Cream ki te puku hei utu. Miria he papa angiangi o te kirīmi capsaicin puta noa i te puku (me nga karapu, kia matara atu i nga kanohi me nga taihemahema) ** whakahoheaTRPV1 nga kaikawe wera** hei ua koropupuke karekau he wera wera, he werawera ranei.
4. ** Rapua he wai me te whakakapi electrolyte a te Tari Ohotata IV mena he pouri, he ngaro ranei te mimi o te turoro CHS e ruaki ana, he uaua nga uaua, he paopao te ngakau, he rangirua, he ruaki toto ranei.
5. Mena kei te pawerawera te tangata, te omaoma te ngakau, te paranoia ranei i muri i te kai i te THC ture ka taea te kai (me te manawa noa me te kore matū waihanga), nekehia ki tetahi ruma atarua, ata noho, me te whakaahuru ka pahemo te tihi. Ka huri te THC-waha i roto i te ate ki te 11-hydroxy-THC, ka eke ki te **2 ki te 12 haora mo te **** mo te 12 haora. Aratakihia te manawa pouaka puhoi, hoatu he wai matao, ka ngaungau, ka hongi ranei te pepa pepa pango katoa, te kiri rēmana ranei (beta-caryophyllene me limonene terpenes ka awhina i te whenua i te awangawanga o te whakaaro).
6. Whakaarohia nga tauhohenga ki te "Spice," "K2," hinu tiriti-vape, te teihana hau ranei "THC-P / HHC / Mushroom" gummies hei paihana hauora e mate ana. Ko nga cannabinoids waihanga katoa te take **status epilepticus (kare e mutu te hopu), hyperthermia, rhabdomyolysis, whiu, me te hihiko o te hōhipera, me te manaakitanga o te hunga kino.

Te Whakatairanga Tere: Te Tautuhia Ko Tehea Ohotata Cannabinoid Kei te Putea¶

flowchart TD
    A["Cannabinoid Emergency ranei"] --> B{"Ko tehea tauira haumanu e taurite ana ki te turoro?"}
    B -->|Young Child / Toddler Ate THC Edible| C["PEDIATRIC EMERGENGENCY: Waea 911 / Whakahaere Paihana Inaianei - He nui te mate o te Koma & Kati te Manawa"]
    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["Acute High-Potency THC Panic / Over-Intoxication"]
    B -->|Used Synthetic Spice, K2, Street Vape, or Unknown Gas-Station Analog| F["KAUPAPA KAUPAPA: Waea wawe ki a 911 - Te Morearea o te Kapohia, te Paanga Manawa, me te Hinengaro."]
    D --> G["1. Whakamutua Katoa Katoa 2. Hoatuhia te Topical Capsaicin 0.075% ki te Kopu 3. Haere ki te ER mo nga Wai IV, Pahakawa, me te Haloperidol/Droperidol mena ka mau tonu te ruaki."]
    E --> H["1. Rua Ataahua Ataahua 2. Whakahauhia te 11-OH-THC Ka eke ki runga i te 2 ki te 4 haora 3. Te Manawa Puturi me te Momi Wai 4. Waea ki te 911 mena ka mamae te uma, te Syncope, te mate hinengaro kore ranei"]

Whakataurite Haumanu o nga Waea ohorere Cannabinoid e wha¶

Wāhanga 1: Cannabinoid Hyperemesis Syndrome (CHS) me te "Scromiting"¶

I whakaahuatia tuatahitia i roto i nga tuhinga rongoa i te tau 2004, a, i whakaingoatia i roto i te Rome IV Diagnostic Criteria for Functional Gastrointestinal Disorders, Cannabinoid Hyperemesis Syndrome (CHS) e pa ana ki nga kaiwhakamahi taumaha, mau tonu o nga hua tarukino (tae atu ki te tarukino rongoa, nga mahi whakangahau, te Delta-8 THC, tae atu ki te CBD te horopeta nui).

1. Ko nga wahanga haumanu e toru o CHS¶

1. Te Wāhanga Prodromal (Marama ki te Tau): Ka puta te nausea i te atatu, he kawa, he ahua "butterfly" ranei i roto i te puku, he wehi ki te ruaki, me te mamae o te puku. Ko te Mahanga Mate: Na te mea ko te tango i te THC mo te wa poto ka whakaohooho i te roro matua CB1 nga kaiwhakawhiwhi ki te huna i te nausea mo te 30 meneti, ka tiimata te tangata ka oho me te pupuhi, te kai paipa ranei i nga ata katoa ki te aukati i te nausea, me te whakanui ake i a raatau kawenga cannabinoid ia ra kia huri ra ano o raatau kaihaa ki te raru.
2. Te Wāhanga Hyperemetic (Acute Emergency: 24 Hours to 10+ Days):
   • Ka puta ohorere ** te nausea me te ruaki o te kaupapa** (he maha ki te 5 ki te 20 nga wa ia haora) me te tangi nui me te mamae o te epigastric ("scromiting").
   • Wai-Hoa Whaonga Horoi Pathognomonic: Neke atu i te 90 paiheneti o nga turoro CHS ka mohio ko te tu i raro i te kaukau wera-wera, te noho ranei i roto i te kaukau koropupu ka whakaora tonu i te mamae o te puku me te nausea, ka hoki mai ano te ruaki i roto i nga meneti ka puta mai i te wai. He maha nga wa i ia ra ka whakahekehia e nga turoro te whakamahana wai wera o to ratau kainga, ka tirotiro ranei ki nga ruma hotera mo te wai wera tonu.
3. Te Wāhanga Whakaora (He wiki ki nga Marama i muri i te 100% Whakamutu): Ka mutu te ruaki i roto i 2 ki te 10 ra ka mutu katoa nga cannabinoids, ka hoki mai te hiahia me te taumaha i roto i nga wiki maha CB1 a TRPV1 ka tautuhia nga kaiwhiwhi. Heoi, mena ka whakamahi te tangata i te tarukino ahakoa kotahi i te wa e ora ana, ka hoki mai ano te wahanga hyperemetic katoa i roto i nga haora, i nga ra ranei.

2. He aha te mahi o te ua wera (me te aha te Topical Capsaicin Cream hei whakakapi hauora haumaru)¶

I roto i te hypothalamus o te tangata (e whakahaere ana i te mahana o te tinana) me te puta noa i nga uaua tairongo o te kohanga whekau, CB1 Ka noho tonu nga kaiwhakawhiwhi cannabinoid ki te taha TRPV1 (Transient Receptor Potential Vanilloid 1) receptors, nga takere katote tika e whakahohehia ana e wera kino (> 43 degrees Celsius / 109 degrees Fahrenheit) me te tiihi-pepa capsaicin.

• I te wa e paheke ana te THC i te horopeta nui CB1 ka mau i te puku me te pararutiki i te puhanga o te puku (gastroparesis), ka pakaru te tohu mamae o te whekau.
• Ka tu i raro i te ua 45-tohu-Celsius (113-tohu-Fahrenheit) ka waipuke te kiri TRPV1 nga nerves me nga tohu wera, te whakaheke toto mai i nga oko whekau splanchnic ki te kiri ("cutaneous steal syndrome") me te whakakore i te pokapū nausea o te roro.
• Me pehea te whakamahi Topical Capsaicin Cream i te kainga, i te whakamatautau ranei hei utu mo nga ua wera:
  1. Hoko paerewa i runga i te kaute 0.025%, 0.075%, 0.1% Capsaicin Cream ranei (hokona i ia whare rongoa mo te mate rumati/ngau uaua).
  2. Ma te whakamahi i nga karapu tuku (he horoi ranei i o ringaringa ki te hopi rīhi i muri iho), ka pania he ** riipene angiangi, te rahi o te pi o te kirīmi capsaicin puta noa i te kiri o te puku (kopu) te tuara ranei o nga ringaringa o runga** kia 3 nga wa ia ra.
  3. Kaua rawa e pania te kirīmi capsaicin i muri tonu mai i te puta mai i te ua wera (tatari kia makariri te kiri ki te pāmahana noa, ka kaha te wera o te wera), kia matara rawa atu i nga kanohi, waha, kiri whati, me nga ira. (Mena ka kaha te wera o te capsaicin, horoia ki te hinu huawhenua tunua, miraka makariri ranei, kaua ki te wai; tirohia. Ka wera te pepa tiihi capsaicin ki nga kanohi, kiri, me nga ringaringa.)
  4. I roto i te 20 ki te 45 meneti, ko te whakamahana o te capsaicin ka whakahohe i te puku. TRPV1 ka mau i te kaikawe me te wawahi i te nausea/mamae karekau e moumou wai tinana i roto i te kaukau wera.

3. Nga haki whero a te Tari Ohotata me te aha i kore ai nga pire nausea paerewa¶

I roto i te tari whawhati tata hōhipera, serotonin paerewa 5-HT3 Ko nga kaiwhaiwhai penei i te ondansetron (Zofran), te promethazine ranei, kaore e tino whai hua ki te CHS nui na te mea ka peia te ruaki e te dopamine/TRPV1/CB1 dysregulation nui atu i te serotonin. Ko nga whakamatautau haumanu matapōkeretia (penei i te HaVOC Trial) kua whakaatu ko te horopeta iti IV haloperidol (0.05 mg/kg ranei 2.5 to 5 mg) ranei IV droperidol, ka honoa ki te 1 ki te 2 rita o te wai tioata IV, te whakakapinga pāhare pāporo/konupora, me te capsaicin puku, ka mutu te ruaki a CHS i te tere rawa atu ka aukati i te whakaurunga ki te hohipera.

Haere tonu ki te Tari Ohotata mena kei te ruaki tetahi o enei haki whero:

• Ko te kore e taea ki te pupuri i te iti noa o te wairewa electrolyte waha mo neke atu i te 12 ki te 18 haora.
• Nga tohu o te Hypokalemia me te tino mate wai: Te uaua o te uaua, te ngoikore ranei o nga waewae, te karekau, te omaomao ranei o te ngakau, te tino mangere, te ngenge ranei i te wa e tu ana, ka maroke nga kanohi totohu, karekau he mimi mo te 8+ haora (he mimi parauri pouri ranei).
• Ko te ruaki i te toto whero kanapa, i nga mea pouri "kawhe-papa" ranei (Mallory-Weiss esophageal roimata i te tutu kino) he haehae ohorere ranei mamae o te uma me te kaki me nga mirumiru hau i raro i te kiri i raro i te kiri (Boerhaave syndrome: te pakaru o te esophageal mate).
• Ko te puku maro, rite te poari, te kirika nui, te mamae o te taha matau-raro-quadrant ranei: Kaua rawa e kii ko te mamae o te puku i roto i te kaiwhakamahi tarukino ko te "CHS noa" tae noa ki te whakakorehia e te taote nga mahi ohorere (apendicitis, pancreatitis, aukati whekau, haputanga ectopic, he poka o te gallbladder ranei).

Wāhanga 2: Whakamatau High-Potency THC Kai Panic Attacks and Over-Intoxication¶

Ko te take tino nui o te toronga ruuma whawhati tata whakapeka tarukino i waenga i nga kaiwhakamahi i etahi wa, i nga tuuruhi, me nga pakeke ko te o-waha THC te kai-a-waha ("kaakaaka".

1. He aha te take i pa atu ai nga kai kai i muri mai i te kai paipa: Te 11-Hydroxy-THC mahanga¶

+-------------------------------------------------------------------------+
|        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.  |
+-------------------------------------------------------------------------+

Na te mea he 60 ki te 120 meneti te roa o te kai hei keri, ka kai tonu nga kaiwhakamahi kaore i te mohio. 10 mg ranei 25 mg he kapia, kare he aha i te 45 meneti, ka kai kia rua, kia toru atu nga kapia i mua tonu i te pa o te horopeta tuatahi ki te ate (te tapae horopeta). E rua haora i muri mai, 50 to 100 mg o 11-hydroxy-THC waipuke ratou roro i te wa kotahi.

2. Taahiraa-i-te-te-te-te-te-te-te-kaainga mo te whakaeke whakamataku THC¶

Ki te pehia te tangata e te THC ture manatoko ka taea te kai, te kakano ranei (kaore he mamae o te uma, ka hopukina, ka pa ki te tarukino waihanga ranei), he maha nga wa ka pa ki a ia te sinus tachycardia (110 to 145 beats per minute), te whakaheke toto (te ahua ka mate i te wa e tu ana), te tohanga o te wa (e 5 meneti te ahua o te 2 haora), me te tino whakapono kei te tu o ratou ngakau, kua wareware ranei ki te manawa aunoa.

1. Waihangahia he Taonga Whakatairanga Iti:
   • Arataki i te tangata ki te rūma noho humarie, karekau te rama, te moenga ranei. Whakawetohia nga puoro nui, nga mata pouaka whakaata e kanapa ana, me nga rama korikori o runga, me te tono atu ki etahi atu mema mano kia wehe atu i te ruma kia kotahi te reo marino, pono kei te korero.
2. Whakaorangia te Whakaaetanga Punga me te Tohu Waa:
   • Korero i roto i te reo puhoi, mahana, take-o-meka: * "I kai koe i te THC kaha te kai i [Wa]. Ko te mea e rongo ana koe i tenei wa ko te 11-hydroxy-THC te tihi i roto i to punaha. Ko to whatumanawa tere ko te hurihanga adrenaline noa mai i te THC, ehara i te mate ngakau. Karekau he tangata i mate mai i te tihi o te hinengaro hinengaro o te taiao taiao e taea ana te kai. ki waho, kei te taamaa e to ate ka marie ake koe.”*
3. ** Takoto Papa, Whakapapahia ranei hei Aukati i te Syncope (Mama):**
   • Ko te THC ka pangia te vasodilation peripheral (te kohi toto i roto i nga waewae), ka paheke ohorere te pehanga toto me te ngoikore ki te tu te tangata ki te hikoi ki te kaukau. Tukuna kia takoto ki raro, ki runga ranei i nga urunga me te hiki o ratou waewae, me te arahi tinana ki te tu ki te whakamahi i te wharepaku.
4. Te Whakatairanga Papanga me te Hangarau Pepa Pango / Rēmana:
   • Tukuna he kaera horoi makuku ki runga i o ratou rae me te tuara o te kaki (whakahohehia te whakapouri ruku whakangote me te nerve vagus ki te whakaroa i te tere o te ngakau).
   • Te Pepa Pango Katoa, Peera Reima Hou ranei: Ki te oho ratou ka taea te horomi humarie, me hongi ratou i te pepa pango hou ka ngaungau ranei 2 ki te 3 pepa pepa pango katoa, ka hongi ranei i te kiri rēmana kuoro me te inu wai rēmana. Kei roto i te pepa pango he taumata teitei o te beta-caryophyllene, he sesquiterpene kai e mahi ana hei kai whiriwhiri CB2 kaiawhina agonist me te kaiwhakaora allosteric kino e whakaatuhia ana i roto i te rangahau cannabinoid haumanu hei whakamaarama i te awangawanga a THC, ko te citrus ** limonene ** ka whakaiti i te paranoia THC whakapeka.
   • Poturi 4-6 Vagal Breathing: Whakaakohia ratou ki te hongi ata i roto i te ihu mo 4 hēkona ka toha marie i roto i nga ngutu mokemoke mo 6 hēkona (ko te whakaroa i te manawa ka whakaihiihi i te reo parasympathetic vagal me te whakaheke i te manawa o te ngakau).
5. He aha nga mea KAUA e mahia i roto i te wahanga ohorere THC:
   • Kaua rawa e hoatu he kawhe, he inu kaha, he waipiro ranei (ka kino te kawheine i te tachycardia me te pawera; ka tino whakanui te waipiro i te whakauru o te THC i roto i te whekau).
   • Kaua rawa e akina ki roto i te ua makariri i te wa e tu ana (ka paheke ohorere te paheketanga o te mahunga, te wharanga mahunga ranei).

Wāhanga 3: Te Whakangao THC Tutuki mo te Pediatric (Humatamatatanga Tino)¶

Ko nga kapia THC arumoni, nga tiakareti, me nga rama-nara-taura ka kapi i nga wa katoa ki roto i nga takai mylar kanapa te ahua he rite tonu te ahua ki te monamona hokomaha auraki, me te kete kotahi kei roto 100 ki te 1,000 milligrams o THC (10 ki te 100 nga pota pakeke).

• He aha te THC Edibles He Whakamate Mo Nga Tamariki me nga Tamariki Iti: I te pakeke e 75 kirokaramu (165 pauna), 50 mg o THC he whakaeke ohorere kino. I roto i te kohungahunga kei te taimaha 12 kirokaramu (26 pauna), ka hopu me te kai i te ringaringa o nga kapia kei roto 100 to 300 mg o THC ka tukuna he horopeta paitini nui (10 to 25 mg/kg).
• Te Huringa Haumanu Pediatric (1 ki te 6 haora i muri i te horomanga):
  • Nga tohu moata (30 ki te 90 meneti): Te hikoi koretake (ataxia), karu karu te karumaru, te katakata, te tangi ohorere ranei, te korero pohehe, me te wiri uaua.
  • Nga tohu tino kino (1 ki te 4 haora): Ka tere haere ki te **hohohohohohoho, te kore e oho ki te whakaoho mamae (coma), tino puhoi, te manawa papaku ranei (bradypnea / apnea e hiahia ana ki te whakauru endotracheal), ka heke te mahana o te tinana (hypothermia), me te tonic-clonic seizures **.
• Te Mahi Inamata mo nga Maatua me nga Kai-tiaki:
  1. Kaua e tatari kia puta mai nga tohu. Na te mea he 1 ki te 2 haora te roa o te kapia waha, ka taea e te tamaiti he ahua tino noa 20 meneti i muri i te kai i te kapia THC ka mutu te manawa i runga i tona moenga e rua haora i muri mai.
  2. Waea 911 / 112 / 999 ranei Mana Paihana (1-800-222-1222 i te US) tonu ka haria te tamaiti ME te takai monamona tika ki te Tari ohorere o te hohipera tata.
  3. Kia 100 paiheneti te pono ki nga kaiparapara me nga taote ER mo te kai a te tamaiti. Ko te korero tonu ki te taote he kai THC tera ka ora te tamaiti mai i nga paopao o te tuara (lumbar punctures), te mahunga CT radiation, me nga patu paturopi kore i te wa e rapu ana nga taote i te take o te koma ohorere.

Wāhanga 4: Cannabinoids Synthetic ("Spice," "K2") me nga Hemp Analogs Kore Whakaritea¶

Kaua rawa e whakapoauau i te tarukino huaota maori me te Synthetic Cannabinoid Receptor Agonists (SCRAs) i hokona hei parakihe otaota ("Spice," "K2," "Black Mamba," "Scooby Snax"), he wai vape kua whakapohehehia, he whakangao hemp semi-synthetic teitei ranei (THC-O-acetate, THC):-P

1. Katoa Agonist Neurotoxicity ("Spice" / "K2"): Natural Delta-9-THC he agonist wahanga anake i te roro CB1 kaiawhina, te tikanga ka pa ana tona paanga ki te tuanui taiao. Ko nga cannabinoids waihanga i hangaia e te taiwhanga ture (penei i MDMB-4en-PINACA, ADB-BUTINACA, a 5F-MDMB-PICA) he agonists ki tonu me te 20 ki te 800 nga wa te kaha o THC. Ko enei ka pa ki te ** ka mau i te mate nui, te hyperthermia nui, te rhabdomyolysis (te pakaru o nga uaua e whakangaro ana i nga whatukuhu), te mokowhiti o te ngakau i roto i nga taiohi, me te hinengaro paranoia kino**.
2. Vitamin E Acetate & Ketene Gas mai i nga Kaata Vape THC-O Illicit: Te whakamahana THC-O-acetate ranei nga hinu vape kino kua tapahia ki te Vitamin E acetate i roto i te pene vape ka pakaru te waiariki i te roopu acetate ki ** hau ketene (CH2=C=O)**, he paihana pūkahukahu whakamate e pa ana ki te phosgene e puta ai EVALI (E-cigarette or Vaping Use-Associated Lung Injury), matū pneumonia, me te mate manawa whakapeka.
3. Brodifacoum ("Superwarfarin" Kiore Poison) Te puremu: He maha nga pakarutanga hauora o te iwi i whaia e te CDC kua whai waahi nga cannabinoids waihanga tiriti kua mapuhia ki te brodifacoum (he paihana kiore roa) ki te whakaroa i te teitei, ka whakaheke toto noa nga turoro mai i o ratou kapia, ihu, puku, me nga whatukuhu i muri mai o nga marama o muri ake nei he whero whero, he whatukuhu (P. Huaora K1 (phytonadione)** rongoā.

Wāhanga 5: Te Whakaora i te Tangotanga o te Cannabis Acute me te Ohoroa Whakahoki I muri i te whakamutu mo te CHS¶

Mo nga turoro e pa ana ki te Cannabinoid Hyperemesis Syndrome, ki te ti'aturi i nga ra katoa (70% to 90% THC wax/vape carts), ko te arai tino uaua ki te noho pai ko te ora i te tua 7 ki te 14 ra o te tangohanga o te tarukino whakapeka me te kore e hoki mai ano ki te aukati i te mamae.

1. Ko te waahi o te tangohanga THC kaha nui¶

I mohiotia i roto i te DSM-5-TR, Ka timata te Cannabis Withdrawal Syndrome (CWS) i roto i te 24 ki te 48 haora ka mutu te whakamahi i ia ra, ka eke ki runga i waenga i nga Ra 2 me te 6, a ka heke te nuinga i roto i te 2 ki te 3 wiki (ahakoa ka taea e te moemoea whakamuri REM ora mo te 30 ki te 45 ra):

• Te Whakahoki Iwi: Te ngaronga o te kai, te ngau o te puku, me te ngenge o te ata. (Otirā, ka pahemo koe i te haora 48 ki te 72 me te kore THC, ka mutu te "scromiting" o CHS, ka whakakapihia e te ngau ngawari.)
• Te Whakahoki Moenga Moe: Na te mea ka pehia e te THC mau tonu te moe ** Rapid Eye Movement (REM) moe**, ma te whakamutua ka puta he mahi nui Rere moe REM: tino ohoroa tuatahi ka whai muri mai i nga moemoea tino maamaa, maamaa, maamaa ranei me nga ** werawera po** e ruku ana i nga peera moenga.
• Mood Disregulation me te Mood: Te ohokore, te irirangi, te riri ohorere, te makariri, te wiri o te ringaringa, me te mahunga.

2. Haumaru, kore-cannabinoid tiaki whakamarie i roto i te 14-ra tautuhi CHS¶

1. Whakaora-waha me te BRAT-Plus Progression:
   • Mo nga haora 48 tuatahi i muri i te whakamutua o te wahanga CHS, horohia te tote whakamahana-a-waha (WHO ORS, Pedialyte, Liquid I.V. ranei), hupa wheua/huawhenua maramara, me nga inu hakinakina kua waimeha ki 15 mira (1 punetēpu) ia 10 meneti, kaua ki te pupuhi i te karaihe o te wai whakakorikori o te gastroco.
   • Kia noho te wai mo te 12 haora, whakaurua nga kai ngawari, iti-ngako (panana, raihi ma, aporo, toast maroke, pihikete tote, me te tii kanekane). A ape i nga kai ngako nui, parai ranei mo te wiki tuatahi, na te mea ko te ngako kai ka whakaroa te putunga o te kopu.
2. Te whakahaere i nga werawera o te po me te ohoroa Whakahoki me te kore e hoki mai ano:
   • Kia whakamahana te whare moenga (16 ki te 18 nga nekehanga Celsius / 60 ki te 65 nga nekehanga Fahrenheit), papaa nga pepa miro whakawha, ka pupuri i te huringa maroke o nga t-hate ki te taha o te moenga.
   • Patai atu ki to rata mo te wa poto mo te moe kore-ahua, te tautoko nausea ranei (penei i te melatonin 1 ki te 3 mg, hydroxyzine, doxylamine, ranei promethazine/prochlorperazine suppositories) i roto i nga ra 1 ki te 7. Kaua rawa e whakamahi hinu CBD, puawai hemp ki raro ranei i te Delta-8 karekau i te waiuwauwauwaawaa CH** phytocannabinoids te taunekeneke me te enteric TRPV1 a CB1 nga kaiwhiwhi me te whakaoho ano i te hyperemesis.

(Mena kei te raru koe, tetahi tangata ranei e whakaaro nui ana koe ki te ti'aturi i ia ra, te whakamahi tarukino waihanga, te mau whakamohoatanga CHS i nga hohipera, tirohia. Te whakamahi matū me te mooni tarukino: aratohu awhina ohorere a Te tautoko i tetahi mema o te whanau e mate ana i te waranga. Ka tūtohu ano matou kia whai koe i tetahi akoranga awhina tuatahi kua whakamanahia mai i te Ripeka Whero, St John Ambulance, tetahi kaiwhakarato rohe ranei.)

Pātai auau¶

Kua tirohia nga puna¶

• American College of Gastroenterology (ACG) and Rome Foundation: Rome IV Diagnostic Criteria and Clinical Practice Guidelines for Cannabinoid Hyperemesis Syndrome (CHS) (Nga waahanga o te CHS, te whakamaaramatanga o te kaukau wai wera, me nga hua whakamutua).
• ** American College of Emergency Physicians (ACEP) & Annals of Emergency Medicine (HaVOC Randomized Trial):** *Intravenous Haloperidol / Droperidol and Topical Capsaicin (0.075% ki te 0.1%) vs.
• ** Pokapū mo te Mana Whakaora me te Aukati Mate (CDC) me te American Association of Poison Control Centres (AAPCC, United States):** Pediatric Unintentional Cannabis Edible Ingestions, Outbreak Advisories on Brodifacoum-Adulterated Synthetic Cannabinoids, me EVALI (Vitamin E Acetate / Keteneid Guidanceng)
• National Institute on Drug Abuse (NIDA / NIH, United States) & World Health Organization (WHO): Pharmacokinetics of waha 11-hydroxy-THC vs Delta-9-THC, me te paitini whakapeka o Full-Agonist Synthetic Cannabinoid Receptor Agonists (Spice / K2).
• British Journal of Pharmacology (Russo, E. B.): Taming THC: Potential Cannabis Synergy and Phytocannabinoid-Terpenoid Entourage Effects (Pharmacology of beta-caryophyllene and limonene in attenuating acute THC anxiety).

Nga kaiarahi e pa ana¶

• Te whakamahi matū me te mooni tarukino: aratohu awhina ohorere
• Te tautoko i tetahi mema o te whanau e mate ana i te waranga
• Nga whakaeke ohorere me te awangawanga nui
• Nga raruraru hauora hinengaro me nga mate ohorere whakamomori
• Ko te paihana kai, ko te gastroenteritis whakapeka, me te matewai
• Ka wera te pepa tiihi capsaicin ki nga kanohi, kiri, me nga ringaringa
• Te paihana awhina tuatahi
• Nga tau ohorere