The Drug-Induced Respiratory Disease Website

Multiple organ dysfunction/failure (MODS/MOF)

Van Rafelghem B, Covaci A, Anseeuw K, van Nuijs ALN, Neels H, Mahieu B, Jacobs W

Suicide by vaping the synthetic cannabinoid 4F-MDMB-BINACA: cannabinoid receptors and fluoride at the crossroads of toxicity?

Forensic science, medicine, and pathology 2021 Dec;17;684-688 — 2021 Dec — 684-688

Armstrong F, McCurdy MT, Heavner MS

Synthetic Cannabinoid-Associated Multiple Organ Failure: Case Series and Literature Review.

Pharmacotherapy 2019 Apr;39;508-513 — 2019 Apr — 508-513

Diagnosing DIRD

Drug and radiation history

Drug singularity - Correct identification of the drug

Consistent timing of exposure v. onset of symptoms

Clinical, imaging, BAL, pathological pattern consistent with the specific drug

Careful exlusion of another cause

Remission of symptoms with removal of drug

Recurrence with rechallenge (rarely advisable)

Causality assessment

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