Question: Tox

D) Lethargy
Edible cannabis (marijuana) products, increasingly legal in many states, contain high doses mg/kg doses of THC for young children. They are often in the form of cookies, candies, baked sweets, and other enticing foods for children. Symptoms include: lethargy, hypotonia, ataxia, altered behavior, mydriasis, tachycardia, sometimes tachypnea, and even seizure. The more typical “adult” symptom of conjunctival injection is less common in children. A high index of suspicion must be kept since parents may not want to disclose the potential exposure or believe it was possible, and since these children often undergo highly invasive work-up and treatment (including e.g. head CT, lumbar puncture, extensive laboratory work, naloxone administration, and intubation) if the true cause of the patient’s symptoms is not suspected. A small percentage of young children that ingest edibles require intubation and artificial ventilation due to their extreme altered mental state and/or bradypnea.