A Case of Hypokalemia with Synthetic Cannabinoid Use
B. Taşkıran, R. Mutluay
2014 DOI: 10.5455/medscience.2014.03.8172 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case study Case report |
|---|---|
| Sample size | 1 |
| Population | A 27-year-old male patient who smoked herbal incense ("Bonzai") and presented to an emergency room |
| Intervention | Potassium chloride (KCl) |
| Dose | 60 meq potassium chloride, then 40 meq KCl |
| Key findings | The authors report a 27-year-old man who developed impaired consciousness, a tonic seizure, and hypokalemia (potassium 2.7 mEq/L) after smoking synthetic cannabinoid incense, with potassium corrected by potassium chloride infusion. They propose that hypokalemia from synthetic cannabinoid use may arise through several mechanisms, including renal potassium loss, loss through sweating or diarrhea, and potassium shift into cells, and caution that vomiting may not be the sole cause. |
Abstract
Synthetic cannabinoids cause a variety of central nervous symptoms, tachycardia and hypokalemia. We report a 27 old male patient was admitted to emergency room due to altered consciousness and vomiting. The patient declared that he smoked herbal incense named Bonzai. After a few hours he was found by his friends with impaired consciousness, no verbal response, and tonic seizure of upper extremities. He vomited once and denied intractable vomiting and diarrhea. His past medical history was nonsignificant and he was not taking any prescription drugs. Potassium (K+) and ethanol concentration was low at the time of admission (2.7 meq/l and 18 mg/dl, respectively). After infusion of 60 meq potassium chloride (KCl), repeat K+ value was 3.5 meq/l. Twenty four hours after admission K+ level dropped to 3.2 meq/l. Potassium level reached to normal value (5 meq/l) after 40 meq KCL infusion. He was discharged uneventfully. Hypokalemia due to synthetic cannabinoid usage may be due to a number of mechanisms including potassium loss via kidneys, potassium loss due to excessive sweating and diarrhea, and potassium shift into cells. Although our patient vomitted once, gastrointestinal loss may not be the sole explanation to hypokalemia. It must be kept in mind that there may be causes of hypokalemia other than vomiting in setting of synthetic cannabinoid use.