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Cristalius: a case in designer drugs
Jared Lenz1, Jaime Brown, Seth Flagg
1Fort Belvoir Community Hospital, 9300 Dewitt Loop, Fort Belvoir, VA 22060, USA.
Military Medicine
|July 4, 2013
Summary
Designer drugs like "bath salts" pose risks. A case study details a patient experiencing syncope and agitation after using Cristalius, highlighting the need for cardiac evaluation and supportive care for synthetic cathinone toxicity.
Area of Science:
- Toxicology
- Emergency Medicine
- Pharmacology
Background:
- Designer drugs marketed as "bath salts" and "plant food" are emerging among recreational users.
- These substances often mimic the stimulant effects of cocaine and amphetamines, or the euphoric effects of MDMA (3,4-methylenedioxy-N-methamphetamine).
- Mephedrone and synthetic cathinone derivatives of the khat plant are primary suspected ingredients.
Observation:
- A 22-year-old male presented to the emergency department with syncope, agitation, confusion, and tachycardia.
- The patient reported snorting 1 gram of a bath salt product named Cristalius the previous night.
- Significant laboratory findings included elevated creatine kinase, serum creatinine, and troponin levels.
Findings:
- The patient's abnormal lab values trended towards normal.
- A computed tomography coronary angiogram revealed no significant abnormalities.
- The patient's symptoms and laboratory abnormalities resolved with supportive care.
Implications:
- No established treatment guidelines exist for mephedrone or MDPV (3,4-methylenedioxypyrovalerone) toxicity.
- Cardiac evaluation is crucial for patients suspected of synthetic cathinone intoxication, irrespective of age.
- Supportive care and management of complications are the cornerstone of treatment for these novel psychoactive substance exposures.
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