Abstract
17 yaşında erkek hasta hastanemiz acil servisine bilinç kapalı, şiddetli bulantı kusma, nöbet geçirme
hikayesi ile başvurdu. Takipleri sırasında solunum arresti olan hastaya orotrakeal entübasyon uygulandı.
Hastaya takip eden zamanda çekilen beyin tomografisinde anlamlı bir bulguya rastlanamadı ve normal
olarak değerlendirildi. Hastanın özgeçmişinde herhangibir hastalık öyküsü bulunamadı. İdrarda
metamfetamin düzeyinin yüksek pozitif olarak tespit edilmesi sonrasında, aileden tekrar detaylı anamnez
alındı. Hasta metamfetamin intoksikasyonu kabul edilerek tedavisine devam edildi.
Hastaya tedavisinin üçüncü gününde çekilen kontrol tomografisinde serebral sulkuslarda silinme ile
seyreden beyin ödemi lehine bulgulara rastlanması üzerine Sodyum tiyopental infüzyonu, hiperventilasyon,
mannitol, deksametazon ve başın optimal pozisyona alınması ve nöbetlerin kontrolü amacıyla fenitoin
tedavisine başlandı. Hastanın tedavisinin 16 gününde laboratuvar bulgularının normale dönmesi sonrasında
yeterli klinik düzelme sağlanarak mekanik ventilasyon desteği sonlandırılarak ekstübe edildi. Takiplerinde
yoğun bakım tedavisi endikasyonu kalmayan hasta tedavisinin 30. gününde taburcu edildi.
Keywords
References
- 1. Evren C, Bozkurt M. Sentetik Kannabinoidler: Son Yılların Krizi. Düşünen Adam The Journal of Psychiatry and Neurological Sciences 2013;26(1):1-11
- 2. Kronstrand R, Roman M, Andersson M, Eklund A. Toxicological findings of synthetic cannabinoids in recreational users. J Anal Toxicol. 2013;37(8):534-41
- 3. Gurney SMR, Scott KS, Kacinko SL, et al. Pharmacology, toxicology, and adverse effects of synthetic cannabinoid drugs; Forensic Sci Rev 2014;26(1):53-78
- 4. Çınar ÖG, Çınar R. Kannabinoid tip 1 reseptör (CB1 ) ve terapötik yaklaşımlara genel bakış. Marmara Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 2012;2(1):1-8.
- 5. Hoyte CO, Jacob J, Monte AA, Al-Jumaan M, Bronstein AC, Heard KJ. A characterization of synthetic cannabinoid exposures reported to the National Poison Data System in 2010. Ann Emerg Med 2012;60(4):435-8
- 6. Kiyatkin EA, Sharma HS. Not just the brain: methamphetamine disrupts blood-spinal cord barrier and induces acute glial activation and structural damage of spinal cord cells. CNS Neurol Disord Drug Targets. 2015;14(2):282-94
Abstract
17 years old male patient admitted to the emergency room of our hospital for unconsciousness, nausea,
vomiting, and seizures story. During follow-up orotracheal intubation was performed because of respiratory
arrest. At that time there were not any significant findings and the taken computed tomography were normal.
There were not any diseases at the patient's history. After identifying positive high levels of
methamphetamine in the urine, another detailed patient history taken from patient's parents. Assuming the
patient's problem as being methamphetamine intoxication, the related threatment was given accordingly.
In the control CTwhich was taken on the third day after admission (CTimage); there were findings in favor of
brain edema such as cerebral sulcus deletions. We began treating patient with sodium thiopental infusion,
hyperventilation, mannitol, dexamethasone, took patient's head to the optimal position and began to
phenytoin therapy for the control of seizures. Mechanical ventilation support was terminated and the patient was extubated during the 16th day of the treatment as laboratory findings got normal and the patient showed
th adequate clinical improvement. He was discharged with healing from ICU on the 30 day.
Keywords
References
- 1. Evren C, Bozkurt M. Sentetik Kannabinoidler: Son Yılların Krizi. Düşünen Adam The Journal of Psychiatry and Neurological Sciences 2013;26(1):1-11
- 2. Kronstrand R, Roman M, Andersson M, Eklund A. Toxicological findings of synthetic cannabinoids in recreational users. J Anal Toxicol. 2013;37(8):534-41
- 3. Gurney SMR, Scott KS, Kacinko SL, et al. Pharmacology, toxicology, and adverse effects of synthetic cannabinoid drugs; Forensic Sci Rev 2014;26(1):53-78
- 4. Çınar ÖG, Çınar R. Kannabinoid tip 1 reseptör (CB1 ) ve terapötik yaklaşımlara genel bakış. Marmara Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 2012;2(1):1-8.
- 5. Hoyte CO, Jacob J, Monte AA, Al-Jumaan M, Bronstein AC, Heard KJ. A characterization of synthetic cannabinoid exposures reported to the National Poison Data System in 2010. Ann Emerg Med 2012;60(4):435-8
- 6. Kiyatkin EA, Sharma HS. Not just the brain: methamphetamine disrupts blood-spinal cord barrier and induces acute glial activation and structural damage of spinal cord cells. CNS Neurol Disord Drug Targets. 2015;14(2):282-94
Details
| Primary Language | Turkish |
|---|---|
| Journal Section | Case Report |
| Authors | |
| Publication Date | December 30, 2015 |
| Submission Date | July 31, 2015 |
| Acceptance Date | August 20, 2015 |
| Published in Issue | Year 2015 Volume: 12 Issue: 3 |
Harran Üniversitesi Tıp Fakültesi Dergisi / Journal of Harran University Medical Faculty