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The Drug-Induced Respiratory Disease Website and App

Cannabinoids - Cannabinoid receptor agonists (synthetic) (K2, Spice)

a.k.a. Spice, K2 bonsai or other colourful names. Include MDMB-CHMICA. Review: PMID 27610597. See also under PMID 27973993. Such adulterants as warfarin or superwarfarins should be examined (PMID 30104022)

Frequency - Incidence

Incidence of respiratory adverse event(s) due to the specific drug as assessed by number of reported/published cases in the literature. Red digits in stars indicate: 0 = Very rare, questionable signal · 1 = < 10 cases · 2 = 10-50 cases · 3 = 50–100 cases · 4 = 100-200 cases · 5 = >200 cases

Evidence level/grade

Evidence level for respiratory adverse event(s) due to the specific drug as estimated using Hill’s (1965), Naranjo’s (1981), and Bégaud’s (1985) criteria applied to published cases. Blue digits in stars indicate: 0 = Questionable · 1 = Low · 2 = Moderate · 3 = Robust · 4 = Definite · 5 = Unquestionable, pathognomonic

I - Interstitial/parenchymal lung disease

I.a

Pneumonitis (ILD), acute and/or severe (may produce the ARDS pattern)
I.c

Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia)
I.e

Acute eosinophilic pneumonia (AEP)
I.ao

Pulmonary infiltrates

II - Pulmonary edema - Acute lung injury - ARDS

II.a

Pulmonary edema, noncardiogenic (NCPE)
II.b

ARDS - Acute lung injury
II.w

Acute respiratory or cardiopulmonary failure

III - Pulmonary/alveolar/airway hemorrhage/bleeding

III.a

Alveolar hemorrhage (AH), diffuse AH (DAH)
III.c

Hemoptysis
III.m

Coagulopathy

VI - Pulmonary vasculopathy

VI.a

Pulmonary embolism - Venous thrombosis/thromboembolism

VII - Mediastinal involvement

VII.h

Pneumomediastinum

VIII - Central-large-upper airway (incl. pharyngeal-nasal) involvement

VIII.b

Hematoma of/around central airway wall potentially causing UAO

IX - Neuromuscular / CNS involvement - Disordered breathing (during sleep)

IX.d

Respiratory failure from ventilatory depression (due to neuromuscular blockade/paralysis)

X - Systemic/Distant conditions, syndromes and reactions

X.u

Multiple organ dysfunction/failure (MODS/MOF)
X.ba

Rhabdomyolysis (see also under Xj)

XI - Miscellaneous

XI.b

Chest pain (acute or subacute), lone or prominent
XI.g

Aspiration, aspiration pneumonia (w/wo demonstrable pharyngeal dysmotility)
XI.r

Death following exposure or poisoning
XI.aa

CNS symptoms or involvement, stroke
XI.bt

Hyperemesis

XII - Cardiovascular involvement / toxicity

XII.g

Coronary artery disease (acute) - Myocardial ischemia/infarction
XII.l

Cardiac arrhythmias or dysrhythmias (AF, VT, VF, TdP)
XII.aj

Systemic arterial thrombosis