• Login
    View Item 
    •   Home
    • UMass Chan Faculty and Staff Research and Publications
    • UMass Chan Faculty and Researcher Publications
    • View Item
    •   Home
    • UMass Chan Faculty and Staff Research and Publications
    • UMass Chan Faculty and Researcher Publications
    • View Item
    JavaScript is disabled for your browser. Some features of this site may not work without it.

    Browse

    All of eScholarship@UMassChanCommunitiesPublication DateAuthorsUMass Chan AffiliationsTitlesDocument TypesKeywordsThis CollectionPublication DateAuthorsUMass Chan AffiliationsTitlesDocument TypesKeywords

    My Account

    LoginRegister

    Help

    AboutSubmission GuidelinesData Deposit PolicySearchingAccessibilityTerms of UseWebsite Migration FAQ

    Statistics

    Most Popular ItemsStatistics by CountryMost Popular Authors

    Sentanyl: a comparison of blood fentanyl concentrations and naloxone dosing after non-fatal overdose

    • CSV
    • RefMan
    • EndNote
    • BibTex
    • RefWorks
    Authors
    Krotulski, Alex J.
    Chapman, Brittany
    Marks, Sarah J.
    Ontiveros, Sam T.
    Devin-Holcombe, Katharine
    Fogarty, Melissa F.
    Trieu, Hai
    Logan, Barry K.
    Merchant, Roland C.
    Babu, Kavita M.
    UMass Chan Affiliations
    Department of Emergency Medicine, Division of Medical Toxicology
    Document Type
    Journal Article
    Publication Date
    2021-07-19
    Keywords
    Fentanyl
    naloxone
    novel psychoactive
    opioid
    overdose
    Emergency Medicine
    Medical Toxicology
    Substance Abuse and Addiction
    Toxicology
    
    Metadata
    Show full item record
    Link to Full Text
    https://doi.org/10.1080/15563650.2021.1948558
    Abstract
    INTRODUCTION: Non-pharmaceutical fentanyl and its analogs have driven striking increases in opioid-associated overdose deaths. These highly potent opioids can be found at low concentrations in biological specimens. Little is known regarding the concentrations of these substances among survivors of non-fatal overdoses. In a locale where fentanyl is responsible for the majority of non-fatal opioid overdoses, we compared the concentration of fentanyl in blood to naloxone dosing in the presence and absence of a concurrent sedative-hypnotic exposure. METHODS: In this pilot study, we enrolled adult patients presenting to the emergency department (ED) who: (1) arrived after an overdose requiring naloxone for the reversal of respiratory depression; and (2) who required venipuncture or intravenous access as part of their clinical care. Blood specimens (n = 20) underwent comprehensive toxicology testing, including the quantitation of fentanyl, fentanyl analogs, and naloxone, as well as the detection of common sedative-hypnotics and a wide range of other illicit and pharmaceutical substances. We then compared fentanyl concentrations to naloxone dosing in participants with and without a concomitant sedative-hypnotic exposure. RESULTS: Nineteen of twenty participants (95%) were exposed to fentanyl prior to their overdose; the remaining participant tested positive for heroin metabolites. No participants reported pharmaceutical fentanyl use. Fentanyl analogs - acetylfentanyl or carfentanil - were present in three specimens. In 11 cases, fentanyl and its metabolites were the only opioids identified. Among the fentanyl-exposed, blood concentrations ranged from < 0.1-19 ng/mL with a mean of 6.2 ng/mL and a median of 3.6 ng/mL. There was no relationship between fentanyl concentration and naloxone dose administered for reversal. We detected sedative-hypnotics (including benzodiazepines, muscle relaxants, and antidepressants) in nine participants. Among the sedative-hypnotic exposed, fentanyl concentrations were lower, but naloxone dosing was similar to those without a concomitant exposure. CONCLUSIONS: In this study, we found that: 1) fentanyl was present in the blood of nearly all participants; 2) fentanyl concentrations were lower among study participants with concomitant sedative-hypnotic exposure; and 3) the dose of naloxone administered for overdose reversal was not associated with the measured fentanyl concentration in blood specimens. Our results underscore the role that tolerance and concomitant drug exposure play in the precipitation and resuscitation of management of opioid overdose.
    Source

    Krotulski AJ, Chapman BP, Marks SJ, Ontiveros ST, Devin-Holcombe K, Fogarty MF, Trieu H, Logan BK, Merchant RC, Babu KM. Sentanyl: a comparison of blood fentanyl concentrations and naloxone dosing after non-fatal overdose. Clin Toxicol (Phila). 2021 Jul 19:1-8. doi: 10.1080/15563650.2021.1948558. Epub ahead of print. PMID: 34278904. Link to article on publisher's site

    DOI
    10.1080/15563650.2021.1948558
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/29913
    PubMed ID
    34278904
    Related Resources

    Link to Article in PubMed

    ae974a485f413a2113503eed53cd6c53
    10.1080/15563650.2021.1948558
    Scopus Count
    Collections
    UMass Chan Faculty and Researcher Publications
    Emergency Medicine Publications

    entitlement

    DSpace software (copyright © 2002 - 2023)  DuraSpace
    Lamar Soutter Library, UMass Chan Medical School | 55 Lake Avenue North | Worcester, MA 01655 USA
    Quick Guide | escholarship@umassmed.edu
    Open Repository is a service operated by 
    Atmire NV
     

    Export search results

    The export option will allow you to export the current search results of the entered query to a file. Different formats are available for download. To export the items, click on the button corresponding with the preferred download format.

    By default, clicking on the export buttons will result in a download of the allowed maximum amount of items.

    To select a subset of the search results, click "Selective Export" button and make a selection of the items you want to export. The amount of items that can be exported at once is similarly restricted as the full export.

    After making a selection, click one of the export format buttons. The amount of items that will be exported is indicated in the bubble next to export format.