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Salvia toxicity
From WikEM
Contents
Background
- Historically used by shamans in rituals
- Active ingredient: Salvinorin A
- Kappa opioid receptor agonist and D2 agonist
- Hallucinogen
- Dissociative effects similar to ketamine
- Tea: 10 min onset, duration 30-90 min
- Smoked: 1-2 minute onset, tapers over 10-20 min and may last up to 1-2 hours
- Does not appear on typical tox screens
Clinical Features
- Uncontrollable laughter
- Intense hallucinations
- Diaphoresis
- Sensations of motion, lights, visions, overlapping realities
- Low toxicity, little hangover, low abuse potential
- Few reports of psychosis and suicide associated with use
Differential Diagnosis
Hallucinogens
- LSD
- 25C-NBOMe
- Phencyclidine
- Mescaline (Peyote)
- Psilocybin/Mushroom Poisoning
- N,N-Dimethyltryptamine
- Ecstasy (MDMA)
- PCP
- Bath Salts
- Salvia toxicity
- Marijuana
- Absinthe
Management
- Supportive
- Benzodiazepines as needed
- Most patients will have symptoms resolve prior to ED arrival given short duration of action
