Cannabinoid Hyperemesis Syndrome (CHS), Agbara giga THC Panic, ati Awọn ounjẹ Sintetiki¶

Lakoko ti taba lile egboigi ti aṣa ni ẹẹkan ninu ** 2 si 4 ogorun delta-9-tetrahydrocannabinol (THC)**, awọn ifọkansi ti iṣowo ode oni, awọn katiriji vape, awọn dabs wax, awọn ami-iṣaaju ti a fi sinu, ati awọn gummies iwọn lilo giga nigbagbogbo nfi 70 si 95 ogorun THC, lẹgbẹẹ hemp-thetic ti ko ni ilana (ace-sC) THC-P, HHC, Delta-8 THC ) ati apaniyan ni kikun sintetiki cannabinoid olugba agonists ("Spice," "K2," MDMB-4en-PINACA, ADB-BUTINACA). Isegun iyalẹnu ni agbara ti ṣẹda awọn pajawiri iṣoogun mẹrin mẹrin ti o kun awọn apa pajawiri ile-iwosan ni gbogbo ọjọ: ** Cannabinoid Hyperemesis Syndrome (CHS)* (“scromiting”: aronizing, eebi projectile cyclical ati ikigbe ni awọn olumulo lojoojumọ onibaje ti o nfa eewu-aye **hypokalemic arrhythmias cardiac ), majele psychosis ***, ** lairotẹlẹ sẹsẹ ati paediatric THC gummy oloro ** (eyi ti o fa coma ati atẹgun şuga ni kekere ọmọ), ati ** synthetic cannabinoid ("Spice") neurotoxicity **.

Nitori THC deede ṣe bi agbo-ẹru-ẹru ni awọn olumulo lẹẹkọọkan, awọn alabara cannabis onibaje ti o jiya lati ** Cannabinoid Hyperemesis Syndrome ** ṣọwọn gbagbọ pe cannabis jẹ idi ti eebi iwa-ipa wọn, ati dipo ẹfin tabi vape * diẹ sii * THC lati yanju awọn ikun wọn, ni idẹkùn ara wọn ni ọmọ-ara ti o lewu. Buru, awọn alaisan ti o wa ni ipele hyperemetic ti CHS nigbagbogbo tii ara wọn ni awọn iwẹ ti o gbona fun wakati 6 si 12 lojumọ lati mu awọn olugba ooru awọ ṣiṣẹ (TRPV1), ijiya pupọ ** awọ ara gbigbona ati gbigbẹ inu iṣan ni iyara ***. Mọ bi o ṣe le ṣe idanimọ awọn ami ami iyasọtọ ti CHS, bii o ṣe le lo ** ipara capsaicin ti oke *** lailewu dipo awọn iwẹ sisun, bawo ni a ṣe le mu ikọlu ijaaya THC nla kan pọ si ni lilo akoko akoko ẹdọ-ẹdọ 11-hydroxy-THC ti idaduro **, ati nigbati lati pe ọkọ alaisan kan fun iparun elekitiroti tabi ingestion ọmọde gba awọn ẹmi là.

Ṣe eyi ni bayi¶

1. Pe nọmba pajawiri ti agbegbe rẹ (911 ni AMẸRIKA ati Kanada, 112 ninu EU, 999 ni UK) lesekese ti ọmọde tabi ọmọde ba jẹ eyikeyi cannabis gummy, chocolate, tabi epo vape, tabi ti agbalagba ba fihan ikọlu, irora àyà, daku, tabi ailagbara lati jẹ ki awọn omi silẹ fun diẹ sii ju wakati 12 si 24 lọ. Ṣayẹwo wa pajawiri awọn nọmba itọsọna, tabi pe Iṣakoso majele (1-800-222-1222 ni Orilẹ Amẹrika). Ko dabi awọn agbalagba, awọn ọmọde ti o wọ awọn ounjẹ THC le yara yara sinu ** coma ti o jinlẹ, ibanujẹ atẹgun ti o lewu (idaduro mimi), ati awọn ijagba.
2. ** Ti olumulo cannabis lojoojumọ ba ni iriri iwa-ipa, atunṣe atunṣe ati irora ikun ti o lagbara nikan ti o ni itusilẹ nipasẹ awọn ojo gbona (Cannabinoid Hyperemesis Syndrome / CHS), Duro GBOGBO THC ATI CBD Lẹsẹkẹsẹ.
3. **Fa alaisan CHS kan kuro ninu awọn ojo ti n sun ki wọn to sun awọ wọn tabi daku lati gbẹ, ki o si lo lori-counter 0.025% si 0.075% Topical Capsaicin Cream si ikun dipo.*TRPV1 awọn olugba ooru *** bi iwẹ ti n ṣan lai fa awọn gbigbona gbigbona tabi gbigbẹ ti o fa lagun.
4. **Wa Ẹka Pajawiri IV omi ati aropo elekitiroti ti alaisan CHS ti o ni eebi ba ni ito dudu tabi ti ko si, iṣan iṣan, palpitations okan, rudurudu, tabi eebi ẹjẹ.
5. ** Ti ẹnikan ba ni ikọlu ijaaya ẹru, ọkan-ije, tabi paranoia lẹhin jijẹ ounjẹ THC ti ofin (pẹlu isunmi deede ati ko si awọn kemikali sintetiki), gbe wọn lọ si baibai, yara idakẹjẹ ki o da wọn loju pe tente oke yoo kọja. Ṣe itọsọna mimi apoti ti o lọra, funni ni omi tutu, ki o jẹ ki wọn jẹ tabi fọn ** odidi ata ilẹ dudu ** tabi peeli lẹmọọn (beta-caryophyllene ati awọn terpenes limonene ṣe iranlọwọ fun ilẹ aniyan awọn iyipo oye).
6. ** Toju eyikeyi esi si "Spice," "K2," ita-vape epo, tabi gaasi-ibudo "THC-P / HHC / Olu" gummies bi a aye-idẹruba egbogi oloro.

Iyatọ ti o yara: idamo Ewo ni pajawiri Cannabinoid N ṣẹlẹ¶

flowchart TD
    A["Cannabis tabi Cannabinoid Pajawiri"] --> B{"Ilana Isẹgun wo ni Baamu Alaisan naa?"}
    B -->|Young Child / Toddler Ate THC Edible| C["Pajawiri ỌMỌDE: Pe 911 / Iṣakoso Majele Bayi - Ewu giga ti Coma & Duro Mimi"]
    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["Agbara giga-giga THC ijaaya / Ọti-Ọmuti"]
    B -->|Used Synthetic Spice, K2, Street Vape, or Unknown Gas-Station Analog| F["ORO SYNTETIC: Pe 911 Lẹsẹkẹsẹ - Ewu ti ikọlu, Ikọlu ọkan, & Psychosis"]
    D --> G["1. Duro gbogbo Cannabis Lẹsẹkẹsẹ 2. Waye Topical Capsaicin 0.075% si Ikun 3. Lọ si ER fun awọn omi IV, Potassium, & Haloperidol/Droperidol ti eebi ba duro"]
    E --> H["1. Yara Dim Idakẹjẹ 2. Ṣe idaniloju 11-OH-THC Peaks ni 2 si 4 Wakati 3. Mimi ti o lọra & SIP Water 4. Pe 911 Nikan ti Irora Aya, Syncope, tabi Psychosis ti ko ni aabo"]

Ifiwera ile-iwosan ti Awọn pajawiri Cannabinoid Mẹrin¶

Part 1: Cannabinoid Hyperemesis Syndrome (CHS) and "Scromiting"¶

First described in medical literature in 2004 and formally codified in the Rome IV Diagnostic Criteria for Functional Gastrointestinal Disorders, Cannabinoid Hyperemesis Syndrome (CHS) affects heavy, chronic users of cannabis products (including medical cannabis, recreational concentrates, Delta-8 THC, and even high-dose CBD combined with THC).

1. The three clinical phases of CHS¶

1. The Prodromal Phase (Months to Years): The person develops early-morning nausea, a sour or "butterfly" feeling in the stomach, fear of vomiting, and mild abdominal discomfort. The Fatal Trap: Because inhaling THC temporarily triggers central brain CB1 receptors to mask nausea for 30 minutes, the person begins waking up and vaping or smoking immediately every morning to stop the nausea, steadily increasing their daily cannabinoid load until their gut receptors tip over into crisis.
2. The Hyperemetic Phase (Acute Emergency: 24 Hours to 10+ Days):
   • Sudden onset of relentless, incapacitating nausea and projectile vomiting (often 5 to 20 times an hour) accompanied by loud vocalizations and wrenching epigastric pain ("scromiting").
   • Pathognomonic Gbona omi Iwa iwẹ: Ju **90 ogorun ti CHS alaisan ** iwari pe duro labẹ a gbigbona iwe tabi joko ni a farabale bathtub lẹsẹkẹsẹ relieves inu wọn irora ati ríru, nikan fun awọn ìgbagbogbo lati pada laarin iṣẹju ti sokale jade ninu omi. Awọn alaisan nigbagbogbo fa ẹrọ igbona omi gbigbona ile wọn ni ọpọlọpọ igba lojumọ tabi ṣayẹwo sinu awọn yara hotẹẹli kan fun omi gbigbona tẹsiwaju.
3. Ipele Imularada (Awọn ọsẹ si Awọn oṣu Lẹhin 100% Idaduro): Eebi duro laarin **2 si ọjọ mẹwa 10 ti idaduro gbogbo awọn cannabinoids patapata, ati ifẹkufẹ deede ati iwuwo pada fun ọsẹ pupọ bi CB1 ati TRPV1 awọn olugba tunto. ** Sibẹsibẹ, ti eniyan ba lo taba lile paapaa ni ẹẹkan lakoko imularada, ipele hyperemetic ni kikun nigbagbogbo tun pada laarin awọn wakati tabi awọn ọjọ.

2. Kini idi ti awọn iwẹ gbona n ṣiṣẹ (ati idi ti Ipara Capsaicin Topical jẹ aropo iṣoogun ailewu)¶

Ninu hypothalamus eniyan (eyiti o ṣe ilana iwọn otutu ara) ati jakejado awọn ara ifarako ti inu ikun, **CB1 cannabinoid awọn olugba joko ọtun tókàn si TRPV1 (O pọju Vanilloid Olugba Olugba 1) awọn olugba *, awọn ikanni ion gangan ti mu ṣiṣẹ nipasẹ ** ooru oloro (> 43 degrees Celsius / 109 degrees Fahrenheit) ati ata capsaicin.

• Nigbati onibaje iwọn lilo giga ti THC desensitizes CB1 awọn olugba ati ki o paralyzing ikun ofo (** gastroparesis ***), ifihan irora ikun lọ haywire.
• Iduro labẹ iwọn 45-Celsius (113-degree-Fahrenheit) ṣiṣan omi ti awọ ara TRPV1 awọn ara pẹlu awọn ifihan agbara ooru, sisọ ẹjẹ silẹ lati inu awọn ohun elo ikun splanchnic si awọ ara (“aisan ji jijẹ-ara”) ati bori ile-iṣẹ ríru ọpọlọ.
• ** Bii o ṣe le lo Ipara Capsaicin Topical ni ile tabi ni ipin dipo awọn iwẹ sisun: ***
  1. Ra boṣewa lori-counter **0.025%, 0.075%, tabi 0.1% Capsaicin Cream *** (ti a ta ni gbogbo ile elegbogi fun arthritis/irora nafu).
  2. Lilo awọn ibọwọ isọnu (tabi fifọ ọwọ daradara pẹlu ọṣẹ satelaiti lẹhinna), fi ** tinrin, ribbon ti o ni iwọn pea ti ipara capsaicin kọja awọ ikun (ikun) tabi ẹhin awọn apa oke ** titi di igba mẹta lojumọ.
  3. **Mase lo ipara capsaicin lesekese ti o ba jade kuro ninu iwe ti o gbona *** (duro titi awọ ara yoo fi tutu si iwọn otutu deede, bibẹẹkọ itara sisun yoo lagbara), ki o jẹ ki o yago fun oju, ẹnu, awọ ti o fọ, ati awọn ẹya ara. (Ti capsaicin ba sun ni agbara pupọ, pa a rẹ pẹlu ** epo elewe tabi wara tutu **, kii ṣe omi; wo Ata capsaicin n sun ni oju, awọ ara, ati ọwọ.)
  4. Laarin **20 si 45 iṣẹju ***, imorusi imorusi ti capsaicin mu ikun ṣiṣẹ TRPV1 awọn olugba ati ki o fọ riru / irora lupu lai jafara omi ara ni kan gbona wẹ.

3. Pajawiri Ẹka pupa awọn asia ati idi ti boṣewa ríru ìşọmọbí kuna¶

Ninu ẹka pajawiri ile-iwosan, serotonin boṣewa 5-HT3 antagonists bii ** ondansetron (Zofran)** tabi promethazine jẹ olokiki ailagbara lodi si CHS ti o lagbara nitori eebi naa jẹ idari nipasẹ dopamine/TRPV1/CB1 dysregulation kuku ju serotonin. Awọn idanwo ile-iwosan laileto (bii ** Iwadii HaVOC *) ti ṣe afihan pe iwọn-kekere ** IV haloperidol (0.05 mg/kg tabi 2.5 to 5 mg) tabi IV droperidol, ni idapo pelu 1 si 2 liters ti omi crystalloid IV, aropo potasiomu/magnesium, ati capsaicin ikun, da eebi CHS duro yiyara ati idilọwọ gbigba ile-iwosan.

** Lọ si Ẹka Pajawiri lẹsẹkẹsẹ ti olumulo cannabis eebi ba ni KANKAN ninu awọn asia pupa wọnyi: ***

• Ailagbara lati tọju paapaa awọn sips kekere ti ojutu electrolyte ẹnu fun ** diẹ sii ju wakati 12 si 18 lọ ***.
• ** Awọn ami ti Hypokalemia & gbigbẹ gbigbẹ:** Isan iṣan tabi ailera ni awọn ẹsẹ, fifẹ tabi awọn iṣọn-ije, dizziness pupọ tabi daku nigbati o dide, awọn oju ti o gbẹ, tabi ** ko si ito fun wakati 8+ (tabi ito dudu dudu)**.
• ** Ebi didan ẹjẹ pupa tabi "kofi-ilẹ" ohun elo dudu ** (Mallory-Weiss esophageal yiya lati iwa-ipa retching) tabi yiya lojiji ** àyà tabi irora ọrun pẹlu awọn nyoju afẹfẹ abẹ awọ labẹ awọ ara *** (** Arun Boerhaave **: rupture esophageal ti o ku).
• ** Rigidi, ikun bi ikun, iba giga, tabi irora isale ọtun-isalẹ:** Maṣe ro pe irora inu ninu olumulo cannabis jẹ “CHS nikan” titi di igba ti awọn pajawiri iṣẹ abẹ eewu ti igbesi aye (appendicitis, pancreatitis, ifun ifun, oyun ectopic, or gallbladder perforation) ti ni aṣẹ nipasẹ dokita kan.

Apakan 2: Agbara giga-giga THC ti o jẹun awọn ikọlu ijaaya ati mimu ọti-lile¶

Idi ti o wọpọ julọ ti awọn abẹwo si yara pajawiri cannabis nla laarin awọn olumulo lẹẹkọọkan, awọn aririn ajo, ati awọn agbalagba agbalagba ni ** ẹnu THC ti o jẹun ni ilokulo (“greening out”)**.

1. Idi ti edibles lu ki Elo le ati ki o nigbamii ju siga: awọn 11-Hydroxy-THC pakute¶

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

Nitoripe ohun ti o jẹun gba ** 60 si 120 iṣẹju *** lati jẹun, awọn olumulo ti ko ni imọran nigbagbogbo jẹun kan. 10 mg tabi 25 mg gummy, ko ni rilara nkankan ni iṣẹju 45, ki o jẹ awọn gummies meji tabi mẹta diẹ sii ni kete ṣaaju iwọn lilo akọkọ deba ẹdọ wọn (** doseji stacking**). Lẹhin wakati meji, 50 to 100 mg ti 11-hydroxy-THC iṣan omi wọn ọpọlọ ni nigbakannaa.

2. Igbesẹ-igbesẹ ile de-escalation fun ikọlu ijaaya THC nla kan¶

Nigbati ẹnikan ba rẹwẹsi nipasẹ iṣeduro THC ti o jẹ ti ofin tabi ṣojumọ (ati pe o ni ** ko si ** irora àyà, ikọlu, tabi ifihan oogun sintetiki), wọn nigbagbogbo ni iriri ** sinu tachycardia (sinus tachycardia).110 to 145 beats per minute),orthostatic hypotension (feeling like they will pass out when standing), time dilation (5 minutes feels like 2 hours), and an overwhelming somatic conviction that their heart is stopping or they have forgotten how to breathe automatically**.

1. Create a Low-Stimulus Sanctuary:
   • Guide the person to a quiet, dimly lit bedroom or couch. Turn off loud music, flashing television screens, and overhead fluorescent lights, and ask extra crowd members to leave the room so only one calm, trusted voice is speaking.
2. Deliver Anchor Reassurance and Time-Stamping:
   • Speak in a slow, warm, matter-of-fact tone: "You ate a strong THC edible at [Time]. What you are feeling right now is 11-hydroxy-THC peaking in your system. Your fast heartbeat is a normal adrenaline reflex from THC, not a heart attack. Nobody has ever died from the psychoactive peak of a natural THC edible. The peak is happening right now at [Current Time], and every 30 minutes from here on out, your liver is clearing it and you will feel calmer."
3. Lie Flat or Reclined to Prevent Syncope (Fainting):
   • THC causes peripheral vasodilation (blood pooling in the legs), which causes a sudden drop in blood pressure and fainting if the person stands up quickly to walk to the bathroom. Keep them lying down or propped on pillows with their legs elevated, and escort them physically if they must stand to use the toilet.
4. Sensory Grounding and the Black Peppercorn / Lemon Technique:
   • Have them place a cool, damp washcloth across their forehead and the back of their neck (activates the mammalian dive reflex and vagus nerve to gently slow heart rate).
   • Whole Black Peppercorns or Fresh Lemon Peel: If they are awake and able to swallow safely, let them sniff freshly cracked black pepper or chew 2 to 3 whole black peppercorns, or sniff grated lemon peel and sip lemon water. Black pepper contains high levels of beta-caryophyllene, a dietary sesquiterpene that acts as a selective CB2 receptor agonist and negative allosteric modulator shown in clinical cannabinoid research to calm THC-induced anxiety, while citrus limonene reduces acute THC paranoia.
   • Slow 4-6 Vagal Breathing: Coach them to inhale slowly through the nose for 4 seconds and exhale gently through pursed lips for 6 seconds (prolonging the exhale stimulates parasympathetic vagal tone and lowers heart rate).
5. What NOT to do during a THC panic episode:
   • Never give caffeine, energy drinks, or alcohol (caffeine worsens tachycardia and panic; alcohol dramatically increases intestinal absorption of THC).
   • Never force them into a cold shower while standing (causes sudden vasoconstriction or a slip-and-fall head injury).

Part 3: Pediatric Accidental THC Gummy Ingestion (Critical Emergency)¶

Commercial THC gummies, chocolate bars, and nerd-rope candies are frequently packaged in brightly colored mylar wrappers that look identical to mainstream supermarket candy, with a single package containing 100 to 1,000 milligrams of THC (10 to 100 adult doses).

• Why THC Edibles Are Life-Threatening to Toddlers and Young Children: In an adult weighing 75 kilograms (165 pounds), 50 mg of THC causes an unpleasant panic attack. In a toddler weighing 12 kilograms (26 pounds), grabbing and eating a handful of gummies containing 100 to 300 mg of THC delivers a massive toxic dose (10 to 25 mg/kg).
• Pediatric Clinical Progression (1 to 6 Hours Post-Ingestion):
  • Early signs (30 to 90 minutes): Unsteady walking (ataxia), glassy dilated eyes, giggling or sudden inconsolable crying, slurred speech, and muscle tremor.
  • Severe signs (1 to 4 hours): Rapid progression to profound lethargy, inability to wake up to painful stimuli (coma), dangerously slow or shallow breathing (bradypnea / apnea requiring endotracheal intubation), drop in body temperature (hypothermia), and generalized tonic-clonic seizures.
• Immediate Action for Parents and Caregivers:
  1. Do NOT wait for symptoms to appear. Because oral gummies take 1 to 2 hours to absorb, a child who looks completely normal 20 minutes after eating a THC gummy can stop breathing in their bed two hours later.
  2. Call 911 / 112 / 999 or Poison Control (1-800-222-1222 in the US) immediately and take the child AND the exact candy wrapper to the nearest hospital Emergency Department.
  3. Be 100 percent honest with the paramedics and ER doctors about what the child ate. Telling the doctor immediately that it was a THC edible saves the child from invasive spinal taps (lumbar punctures), head CT radiation, and unnecessary antibiotics while doctors search for the cause of sudden coma.

Part 4: Synthetic Cannabinoids ("Spice," "K2") and Unregulated Hemp Analogs¶

Never confuse natural botanical cannabis with Synthetic Cannabinoid Receptor Agonists (SCRAs) sold as herbal incense ("Spice," "K2," "Black Mamba," "Scooby Snax"), adulterated street vape liquid, or high-potency semi-synthetic hemp derivatives (THC-O-acetate, THC-P, HHC):

1. Full Agonist Neurotoxicity ("Spice" / "K2"): Natural Delta-9-THC is only a partial agonist at brain CB1 receptors, meaning its physiological effect hits a natural ceiling. Illicit lab-made synthetic cannabinoids (such as MDMB-4en-PINACA, ADB-BUTINACA, and 5F-MDMB-PICA) are full agonists with 20 to 800 times the potency of THC. They trigger fatal grand mal seizures, extreme hyperthermia, rhabdomyolysis (muscle breakdown destroying the kidneys), coronary artery spasm causing heart attacks in teenagers, and violent paranoid psychosis.
2. Vitamin E Acetate & Ketene Gas from Illicit THC-O Vape Cartridges: Heating THC-O-acetate or illicit vape oils cut with Vitamin E acetate in a vape pen thermally cracks the acetate group into ketene gas (CH2=C=O), a lethal pulmonary poison chemically related to phosgene that causes EVALI (E-cigarette or Vaping Use-Associated Lung Injury), chemical pneumonia, and acute respiratory failure.
3. Brodifacoum ("Superwarfarin" Rat Poison) Adulteration: Multiple public health outbreaks tracked by the CDC have involved street synthetic cannabinoids sprayed with brodifacoum (long-acting rat poison) to prolong the high, causing patients to bleed spontaneously from their gums, nose, stomach, and kidneys (bright red blood in urine) days later, requiring months of high-dose Prescription Vitamin K1 (phytonadione) therapy.

Part 5: Surviving Acute Cannabis Withdrawal and Rebound Insomnia After Quitting for CHS¶

For patients diagnosed with Cannabinoid Hyperemesis Syndrome or daily high-potency concentrate dependence (70% to 90% THC epo-eti / awọn kẹkẹ vape), idena ti o nira julọ lati duro daradara ni iwalaaye ** akọkọ 7 si awọn ọjọ 14 ti yiyọkuro cannabis nla ** laisi ifasẹyin lati da aibalẹ naa duro.

1. Awọn Ago ti ńlá ga-agbara THC yiyọ kuro¶

Ti idanimọ ni DSM-5-TR, Cannabis Withdrawal Syndrome (CWS) bẹrẹ laarin 24 si 48 wakati ti didaduro lilo lojoojumọ, awọn oke laarin awọn ọjọ 2 ati 6 ***, ati ni pataki laarin **2 si ọsẹ 3 *** (botilẹjẹpe awọn ala isọdọtun REM le ṣiṣe ni fun ọjọ 45):

• ** Ipadabọ Ifun inu:** Pipadanu ounjẹ, jijẹ inu rirọ, ati ikilọ owurọ. (Ni pataki, ni kete ti o ba kọja wakati 48 si 72 laisi THC, cyclic “scromiting” iwa-ipa ti CHS duro ati pe o rọpo nipasẹ aibalẹ kekere ti o le ṣakoso.)
• Ipadabọ faaji oorun: Nitoripe THC onibaje npa **Rapid Eye Movement (REM) orun **, didasilẹ nfa iyalẹnu kan ** isọdọtun oorun REM **: insomnia ibẹrẹ ti o nira ti o tẹle pẹlu awọn alaburuku ti o han gedegbe, burujai, tabi awọn alaburuku lucid ati lọpọlọpọ ** lagun alẹ *** ti o fa awọn iwe ibusun naa.
• Adaṣe & Iṣatunṣe Iṣesi: Aisimi, ibinu, ibinu ojiji, otutu, gbigbọn ọwọ kekere, ati orififo.

2. Ailewu, itọju itunu ti kii-cannabinoid lakoko 14-ọjọ CHS tunto¶

1. ** Atunṣe Oral ati Ilọsiwaju BRAT-Plus: ***
   • Fun wakati 48 akọkọ lẹhin iṣẹlẹ CHS kan duro, sip ** awọn iyọ isọdọtun ẹnu ti o tutu (WHO ORS, Pedialyte, tabi Liquid I.V.), eegun eegun/ọbẹ ẹfọ, ati awọn ohun mimu ere idaraya ti a fomi ni * milimita 15 (1 tablespoon) ni gbogbo iṣẹju mẹwa 10 ti o jẹ ki o fa gilasi kikun ti omi isan gafle (xco).
   • Ni kete ti awọn olomi ba wa ni isalẹ fun awọn wakati 12, ṣafihan Bland, awọn ounjẹ ti ko sanra (** ogede, iresi funfun lasan, applesauce, tositi gbigbẹ, awọn crackers saltine, ati tii ginger**). Yago fun ọra-giga tabi awọn ounjẹ didin fun ọsẹ akọkọ, bi ọra ti ijẹunjẹ ṣe fa fifalẹ didasilẹ inu.
2. ** Ṣakoso awọn lagun alẹ ati Ipadabọ Insomnia Laisi Ipadabọ: ***
   • Jeki yara naa dara (** 16 si 18 iwọn Celsius / 60 si 65 iwọn Fahrenheit ***), awọn aṣọ owu ti o ni ẹmi, ki o tọju iyipada gbigbẹ ti awọn t-shirt lẹgbẹẹ ibusun.
   • Beere lọwọ dokita rẹ nipa oorun ti kii ṣe ihuwasi fun igba diẹ tabi atilẹyin ọgbun (gẹgẹbi ** melatonin 1 si 3 mg ***, hydroxyzine, doxylamine, tabi promethazine/prochlorperazine suppositories) lakoko Ọjọ 1 nipasẹ 7. Maṣe lo awọn epo CBD, hemp vapeHS tabi Delta si isalẹ phytocannabinoids ti kii ṣe ọti-lile ṣe ibaraenisepo pẹlu enteric TRPV1 ati CB1 awọn olugba ati tun-fa hyperemesis.

(Ti iwọ tabi ẹnikan ti o nifẹ si ti n tiraka pẹlu igbẹkẹle cannabis agbara giga lojoojumọ, lilo oogun sintetiki, tabi awọn ile-iwosan ti CHS loorekoore, wo Lilo nkan elo ati afẹsodi oogun: itọsọna iranlọwọ pajawiri ati N ṣe atilẹyin ọmọ ẹgbẹ ẹbi kan pẹlu afẹsodi. A tun ṣeduro gbigba iṣẹ iranlọwọ akọkọ ti ifọwọsi lati Red Cross, St John Ambulance, tabi olupese agbegbe kan.)

Awọn ibeere ti a beere nigbagbogbo¶

Awọn orisun ṣayẹwo¶

• ** Ile-ẹkọ giga ti Ilu Amẹrika ti Gastroenterology (ACG) ati Rome Foundation: *** Rome IV Awọn Imudaniloju Aṣayẹwo ati Awọn Itọsọna Iṣeduro Iṣegun fun Cannabinoid Hyperemesis Syndrome (CHS) * (Awọn ipele ti CHS, ipaniyan omi-gbigbona iwẹwẹ pathophysiology, ati awọn abajade ipari ipari).
• ** Ile-ẹkọ giga ti Ilu Amẹrika ti Awọn Onisegun Pajawiri (ACEP) & Awọn akọọlẹ ti Oogun Pajawiri (Iwadii Laileto HaVOC):** *Haloperidol inu iṣọn-ẹjẹ / Droperidol ati Topical Capsaicin (0.075% si 0.1%) vs. Ondansetron ninu Ẹka pajawiri Iṣakoso ti Cannabinoid Hyperemesis Syndrome *.
• ** Awọn ile-iṣẹ fun Iṣakoso ati Idena Arun (CDC) ati Ẹgbẹ Amẹrika ti Awọn ile-iṣẹ Iṣakoso majele (AAPCC, United States): *** * Awọn ingestions Cannabis Ainidii ti Ọmọde *, * Awọn imọran Ibesile lori Brodifacoum-Adulterated Synthetic Cannabinoids *, ati * EVALI (Vitamin E Acetateng / Ketery)id.
• Ile-ẹkọ ti Orilẹ-ede lori ilokulo Oògùn (NIDA / NIH, United States) & Ajo Agbaye fun Ilera (WHO): Pharmacokinetics ti ẹnu 11-hydroxy-THC vs ifasimu Delta-9-THC, ati toxicology ńlá ti Full-Agonist Synthetic Cannabinoid Receptor Agonists (* Spice / K2*).
• ** Iwe akọọlẹ Ilu Gẹẹsi ti Pharmacology (Russo, E. B.):** * Taming THC: Agbara Cannabis Synergy ati Awọn ipa ipadabọ Phytocannabinoid-Terpenoid * (Pharmacology ti beta-caryophyllene ati limonene ni idinku aifọkanbalẹ THC nla).

Jẹmọ awọn itọsọna¶

• Lilo nkan elo ati afẹsodi oogun: itọsọna iranlọwọ pajawiri
• N ṣe atilẹyin ọmọ ẹgbẹ ẹbi kan pẹlu afẹsodi
• Awọn ikọlu ijaaya ati aibalẹ nla
• Aawọ ilera ọpọlọ ati awọn pajawiri suicidal
• Majele ounje, gastroenteritis nla, ati gbígbẹ
• Ata capsaicin n sun ni oju, awọ ara, ati ọwọ
• Majele akọkọ iranlowo
• Awọn nọmba pajawiri