Kratom toxicity: Difference between revisions
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*Derived from ''Mitragyna speciosa,'' a plant native to Southeast Asia | *Derived from ''Mitragyna speciosa,'' a plant native to Southeast Asia | ||
*Contains numerous chemicals acting on mu opioid, adrenergic, serotonin, and GABA receptors | *Contains numerous chemicals acting on mu opioid, adrenergic, serotonin, and GABA receptors | ||
*Increasingly popular in US for attempted self-treatment of pain, opioid addiction/withdrawal | *Increasingly popular in US for attempted self-treatment of pain, opioid addiction/withdrawal, and depression | ||
**Patients often perceive incorrectly as a "safe" alternative to opioids | **Patients often perceive incorrectly as a "safe" alternative to opioids | ||
Revision as of 18:27, 27 June 2019
Background
- Derived from Mitragyna speciosa, a plant native to Southeast Asia
- Contains numerous chemicals acting on mu opioid, adrenergic, serotonin, and GABA receptors
- Increasingly popular in US for attempted self-treatment of pain, opioid addiction/withdrawal, and depression
- Patients often perceive incorrectly as a "safe" alternative to opioids
Clinical Features
- Effects are dose dependent and may mimic those of both opioid and stimulant toxicity
- Stimulant effects typically predominate at low doses (<5 g) with sedating effects more prevalent at higher doses
Differential Diagnosis
Evaluation
- Clinical diagnosis
- Labs not routinely required unless severe vomiting, seizure, or unclear diagnosis
Management
- Management should be tailored to primary symptoms
- Naloxone for respiratory depression
- Benzodiazepines for hyperarousal, tachycardia, hypertension, and seizures
- NSAIDs, antiemetics, fluids, etc. for opioid withdrawal symptoms
- Medication-assisted treatment with buprenorphine or methadone
Disposition
- Discharge unless presenting with severe/intractable symptoms