cannabinoid_hyperemesis
Table of Contents
cannabinoid hyperemesis
see also:
introduction
- 1st identified as a syndrome in Australia in 2004
- classically associated with relief from hot showers resulting in compulsive showers/bathing
- cyclical every 2-3weeks
- anti-emetics generally do not work well
- take care to exclude other important causes before deciding upon this diagnosis and ensure the features do match the syndrome
- unfortunately, this may lead to over-investigation with CT scans on multiple visits - the decision to not do a scan should be based on solid clinical reasoning
diagnosis
- long term chronic cannabis/marijuana use with current weekly use
- cyclic nausea and vomiting
- relief of symptoms with hot showers or baths
- +/- abdominal pain
- +/- mainly in mornings
- other diagnoses excluded
Rx
- consider iv rehydration and correction of electrolyte disturbances if present
- advise cessation of cannabis use
- consider trial of promethazine
- consider trial of topical 0.075% capsaicin cream to trunk
- if severely distressed consider:
- low dose benzodiazepines such as iv midazolam 0.5-1mg
- iv droperidol (Droleptan) 1-2.5mg iv
cannabinoid_hyperemesis.txt · Last modified: 2024/08/20 09:52 by gary1