Diagnóstico, Manejo y Seguimiento de los Pacientes Intoxicados con derivados de Cannabis: una revisión narrativa

Contenido principal del artículo

MD Juan Jose Cordero-Solís
Bach Diego Delgado-Gómez
Bach Juan Santillán-Zúñiga

Keywords

cannabis, intoxicación, toxicología

Resumen

El uso de cannabis a nivel mundial ha tenido un auge en los últimos años, según datos de la Organización Mundial de la Salud, tendencia que de igual manera se ha manifestado en Costa Rica. Además, los diferentes componentes químicos de la marihuana se asocian a un uso variado de la misma tal como recreacional, medicinal, o cosméticamente. Lo anterior va a incidir directamente en que exista una mayor posibilidad de que los usuarios presenten un cuadro de intoxicación de marihuana por su uso inadecuado, por lo cual es primordial que los médicos y demás personal de salud logren identificar el cuadro clínico de un paciente intoxicado con cannabis, así como saber realizar un manejo integral y brindar el seguimiento adecuado de estas personas, para así minimizar el riesgo de posibles consecuencias nocivas atribuibles al consumo de cannabis.

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Citas

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United Nations. World Drug Report 2020. 2020;11–2. Disponible en:
https://wdr.unodc.org/wdr2020/field/WDR20_Booklet_2.pdf
2. Grof C. Cannabis, from plant to pill. Br J Clin Pharmacol. 2018;1–15.





3. Wilkinson S, Yarnel S, Radhakrishnan R, Ball S, Cyril D. Marijuana Legalization: Impact on Physicians and Public Health. Annu Rev Med. 2016;67(1):453–66.
4. Comisión Interamericana Abuso De Drogas Control del. Informe sobre el consumo de drogas en las Américas, 2019. 2019;67–75.
5. Chandra S, Radwan M, Majumbar C, Church J, Freeman T, ElSohly M. New trends in cannabis potency in USA and Europe during the last decade (2008–2017). Eur Arch Psychiatry Clin Neurosci. 2019;1–11.
6. Naciones Unidas. Informe Mundial sobre las Drogas [Internet]. 2019. Disponible en: https://wdr.unodc.org/wdr2019/field/B2_S.pdf
7. Zeledón G. PERFIL EPIDEMIOLÓGICO DE INTOXICACIONES EN COSTA RICA, 2017 [Internet]. San Jose; 2018. Disponible en: https://www.redciatox.org/sites/default/files/webfiles/2018/datos_toxico_cor_2017.pdf
8. Instituto sobre Alcoholismo y Farmacodependencia [Internet]. 2020. Disponible en: https://www.iafa.go.cr/
9. Lewis B, Fleeger T, Judge B, Riley B, Jones J. Acute toxicity associated with cannabis edibles following decriminalization of marijuana in Michigan. Am J Emerg Med. 2020;
10. Grimaldi A, Giglio L, Haggiag S, Bianco A, Cortese A, Giuseppe S, et al. The influence of physiotherapy intervention on patients with multiple sclerosis–related spasticity treated with nabiximols (THC:CBD oromucosal spray). PLoS One. 2019;14(7):1–10.
11. Lim M, Kirchhof M. Dermatology-Related Uses of Medical Cannabis Promoted by Dispensaries in Canada, Europe, and the United States. J Cutan Med Surg. 2018;




12. Kleine-Brueggeney M, Greif R, Brenneisen R, Urwyler N, Stueber F, Theiler L. Intravenous Delta-9 Tetrahydrocannabinol to Prevent Postoperative Nausea and Vomiting: A Randomized Controlled Trial. Anesth Analg. 2015;121(5):1157–64.
13. Huestis MA, Solimini R, Pichini S, Pacifici R, Carlier J, Busardò FP. Cannabidiol Adverse Effects and Toxicity. Curr Neuropharmacol. 2019;17(10):974–89.
14. Pagano S, Coniglio M, Valenti C, Federici MI, Lombardo G, Cianetti S, et al. Biological effects of Cannabidiol on normal human healthy cell populations: Systematic review of the literature. Biomed Pharmacother [Internet]. 2020;132:110728. Disponible en: https://doi.org/10.1016/j.biopha.2020.110728
15. Amin MR, Ali DW. Pharmacology of Medical Cannabis. Adv Exp Med Biol. 2019;1162:151–65.
16. Lucas CJ, Galettis P, Schneider J. The pharmacokinetics and the pharmacodynamics of cannabinoids. Br J Clin Pharmacol. 2018;84(11):2477–82.
17. Bellocchio L, Inchingolo AD, Inchingolo AM, Lorusso F, Malcangi G, Santacroce L, et al. Cannabinoids drugs and oral health—from recreational side-effects to medicinal purposes: A systematic review. Int J Mol Sci. 2021;22(15).
18. Weier A, Kleinschmidt K. How Are Patients Who Are Admitted to the Intensive Care Unit after Common Poisonings Diagnosed and Managed? [Internet]. Evidence-Based Practice of Critical Care. Elsevier Inc.; 2006. 632–636 p. Disponible en: http://dx.doi.org/10.1016/B978-1-4160-5476-4.00090-0
19. Noble MJ, Hedberg K, Hendrickson RG. Acute cannabis toxicity. Clin Toxicol [Internet]. 2019 [cited 2021 May 9];57(8):735–42. Disponible en:





https://www.tandfonline.com/doi/full/10.1080/15563650.2018.1548708
20. Chen Y, Klig J. Cannabis-related emergencies in children and teens. Curr Opin Pediatr. 2019;31(3):291–6.
21. Claudet I, Le Breton M, Bréhin C, Franchitto N. A 10-year review of cannabis exposure in children under 3-years of age: do we need a more global approach? Eur J Pediatr [Internet]. 2017 [cited 2021 May 9];176(4):553–6. Available from: http://link.springer.com/10.1007/s00431-017-2872-5
22. Emoto J, Weeks K, Kallail KJ. Accidental Acute Cannabis Intoxication Presenting as Seizure in Pediatrics Patients. Kansas J Med. 2020;13:129–30.
23. Richards JR, Smith NE, Moulin AK. Unintentional Cannabis Ingestion in Children: A Systematic Review. J Pediatr [Internet]. 2017;190:142–52. Disponible en: https://doi.org/10.1016/j.jpeds.2017.07.005
24. Onders B, Casavant MJ, Spiller HA, Chounthirath T, Smith GA. Marijuana Exposure Among Children Younger Than Six Years in the United States. Clin Pediatr (Phila) [Internet]. 2016 May [cited 2021 May 9];55(5):428–36. Disponible en: http://journals.sagepub.com/doi/10.1177/0009922815589912
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26. Boadu O, Gombolay GY, Caviness VS, El Saleeby CM. Intoxication From Accidental Marijuana Ingestion in Pediatric Patients: What May Lie Ahead. Pediatr Emerg Care. 2020;36(6):e349--e354.
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https://linkinghub.elsevier.com/retrieve/pii/S2215036619300860
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https://onlinelibrary.wiley.com/doi/abs/10.1111/acem.13393
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