Adherence to Long-Term Follow-Up of Patients with Life-Threatening, Inhaled Synthetic Cannabinoids-Associated Coagulopathy in Chicago.

Authors:
Israel Rubinstein
Israel Rubinstein
University of Illinois at Chicago
United States

Lung 2019 Jun 19;197(3):349-352. Epub 2019 Apr 19.

Division of Pulmonary, Critical Care, Sleep and Allergy Medicine, Department of Medicine (M/C 719), University of Illinois at Chicago, 840 South Wood Street, Chicago, IL, 60612, USA.

A large-scale outbreak of life-threatening, inhaled synthetic cannabinoids (Spice/K2)-associated coagulopathy with bleeding complications was recently reported in Illinois. The causative agents were brodifacoum, difenacoum, and bromadiolone, potent, long-acting, 4-hydroxycoumarin anticoagulant rodenticides (LAAR) that were mixed with Spice/K2 products procured and then inhaled by the victims. We report on 3 poisoned patients who reside in underserved, socioeconomically disadvantaged neighborhoods of Chicago that were admitted and treated successfully at two inner-city, tertiary care hospitals in Chicago. The patients were discharged from the hospitals on daily long-term high-dose oral vitamin K (VK), provided free of charge. However, 2 patients were lost to follow-up prior to safe discontinuation of oral VK therapy. The third patient was treated and followed successfully for 7 months when VK was discontinued. We conclude that prolonged oral VK therapy and follow-up of acute, life-threatening LAAR poisoning are variable and present challenges to healthcare providers. Appropriate practice guidelines to improve patient access and adherence to daily high-dose oral VK therapy and follow-up should be developed and implemented.

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Source
http://dx.doi.org/10.1007/s00408-019-00227-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6522275PMC
June 2019

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