The Drug-Induced Respiratory Disease Website

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

Coagulopathy

May stem from thrombocytopenia or pancytopenia, DIC, drug-drug interaction with an vitamin K antagonist, or direct vitamin K antagonism. May lead to any pattern of bleeding under pattern family II

Publications

Tole M, LaBedz S, Feinstein DL, Rubinstein I

Adherence to Long-Term Follow-Up of Patients with Life-Threatening, Inhaled Synthetic Cannabinoids-Associated Coagulopathy in Chicago.

Lung 2019 Jun;197;349-352 — 2019 Jun — 349-352

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

Diagnosing DIRD

Identify causative drugs

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