Title: Not your ordinary Bath product<br/>Author: Kishan Kapadia<br/><a href='http://umem.org/profiles/faculty/1143/'>[Click to email author]</a><hr/><p>
        Bath salts (synthetic cathinones) commonly contain multipe synthetic drugs and can be ingested, smoked, or administered intravenously.  The designer stimulant mephedrone (4-methylcathinone) is among the most popular of the derivatives of the naturally occurring psychostimulant cathinone.  Bath salt use is on the rise and is responsible for a large number of ED visits.</p>
<p>
        In spite of their ban, bath salts are still available over the counter in specialty shops and through the Internet with common product names such as: "Ivory Wave," "Cloud 9," "Purple Wars," "Vanilla Sky," "Bliss," etc.  They are commonly marketed with the disclaimer, "<em><strong>not for human consumption.</strong></em>" </p>
<p>
        Their presentation mimics other sympathetic drugs through pathways similar to amphetamines.  The primary psychological effects have a duration of roughly 3-4 hours, with physiologic effects lasting from 6-8 hours.</p>
<table align="center" border="1" cellpadding="1" cellspacing="1" style="width: 500px;">
        <tbody>
                <tr>
                        <td style="text-align: center;">
                                <strong>Physical Effects                       </strong></td>
                        <td style="text-align: center;">
                                <strong>Behavioral & Mental Status Effects</strong></td>
                </tr>
                <tr>
                        <td>
                                Tachycardia</td>
                        <td>
                                Agitation</td>
                </tr>
                <tr>
                        <td>
                                Hypertension</td>
                        <td>
                                Paranoia</td>
                </tr>
                <tr>
                        <td>
                                Dysrhythmias</td>
                        <td>
                                Hallucinations</td>
                </tr>
                <tr>
                        <td>
                                Hyperthermia</td>
                        <td>
                                Psychosis</td>
                </tr>
                <tr>
                        <td>
                                Seizures</td>
                        <td>
                                Violent behavior</td>
                </tr>
                <tr>
                        <td>
                                Sweating</td>
                        <td>
                                Delusions</td>
                </tr>
        </tbody>
</table>
<p>
        Management is largely supportive and includes IV hydration, benzodiazepines, and close monitoring in the ICU setting.</p>
<p>
         </p>
<fieldset><legend>References</legend>

                <p>
        Imam SF, Patel H, Mahmoud M, et.al. Bath salts intoxication: A case series. <em>JEM</em> 2013;45(3):361-365.</p>
</fieldset>