Identification of a novel opioid, N-piperidinyl etonitazene (etonitazepipne), in patients with suspected opioid overdose.
Identification of a novel opioid, N-piperidinyl etonitazene (etonitazepipne), in patients with suspected opioid overdose.
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DOI：
10.1080/15563650.2022.2084406
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发表时间：
2022-09
影响因子：
3.3
通讯作者：
Manini, Alex F.
中科院分区：
文献类型：
--
作者：
Calello, Diane P.;Aldy, Kim;Jefri, Mohamed;Nguyen, Tuyet-Anh T.;Krotulski, Alex;Logan, Barry;Brent, Jeffrey;Wax, Paul;Walton, Sara;Manini, Alex F.
非法药物供应中的新型阿片类药物，例如“奈他泽”类合成阿片，由于效力强且具有呼吸抑制作用，带来了持续的公共卫生问题。我们描述了3名患者，在怀疑阿片类药物过量后，检测到了N - 哌啶基依托奈他泽，这是一种此前未在人体暴露中被报道过的化合物。这些患者检测的其他物质包括芬太尼、可卡因、左旋咪唑、非那西丁、苯甲酰爱康宁、对氟芬太尼、疑似海洛因（检测为6 - 单乙酰吗啡(6 - MAM)、吗啡和可待因）以及曲马多。
这是一个正在进行的多中心前瞻性队列研究中纳入的急性阿片类药物过量患者的病例系列。收集的数据包括报告的药物使用情况、临床病程、纳洛酮剂量和反应、结果以及生物样本中检测到的分析物。
在2020年10月6日至2021年10月31日期间，对1006名患者进行了筛选，其中412名符合纳入标准。在此期间，2021年7月的三天内，新泽西州的一个地点有3名患者（年龄33 - 55岁）的N - 哌啶基依托奈他泽检测呈阳性。2名患者报告使用了可卡因；1名患者报告使用了海洛因和阿普唑仑。所有3名患者都接受了纳洛酮治疗，精神状态有所改善（2毫克经鼻给药；8毫克经鼻给药；0.08毫克静脉注射）。3名患者中有2名因阿片类药物毒性复发接受了后续剂量（0.4 - 0.6毫克静脉注射）。1名患者被诊断为肺炎并入住重症监护病房，1名从急诊科出院，1名在急诊科期间使用了其他药物，需要住院接受纳洛酮输注。无患者出现器官损伤或后遗症。
这些病例代表了一种新型“奈他泽”类阿片的局部暴发。公共卫生毒物监测应将对非法药物供应中这类新兴合成化合物的常规检测纳入其中。
Novel opioids in the illicit drug supply, such as the “nitazene” group of synthetic opioids, present an ongoing public health problem due to high potency and respiratory depressant effects. We describe three patients in whom N-piperidinyl etonitazene, a compound not previously reported in human exposure, was detected after suspected opioid overdose. Other substances that these patients tested for included fentanyl, cocaine, levamisole, phenacetin, benzoylecgonine, para-fluorofentanyl, presumptive heroin (tested as 6-monoacetylmorphine (6-MAM), morphine, and codeine), and tramadol. This is a case series of patients with acute opioid overdose enrolled in an ongoing multicenter prospective cohort study. Data collected included reported substance use, clinical course, naloxone dose and response, outcome, and analytes detected in biological samples. Between October 6, 2020 and October 31, 2021, 1006 patients were screened and 412 met inclusion criteria. Of these, three patients (age 33–55) tested positive for N-piperidinyl etonitazene at one site in New Jersey over a period of three days in July 2021. Two patients reported the use of cocaine; one reported the use of heroin and alprazolam. All three patients received naloxone with improvement in their mental status (2 milligrams (mg) intranasally (IN); 8 mg IN; 0.08 mg intravenous (IV)). Two of three received subsequent doses for recurrence of opioid toxicity (0.4–0.6 mg IV). One patient was diagnosed with pneumonia and admitted to the intensive care unit, one was discharged from the Emergency Department (ED), and one used additional drug while in the ED and required admission for a naloxone infusion. None developed organ damage or sequelae. These cases represent a local outbreak of a novel “nitazene” opioid. Public health toxicosurveillance should incorporate routine testing of this emerging class of synthetic compounds in the illicit drug supply.
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影响因子：
2.9
作者：
Krotulski, Alex J.;Papsun, Donna M.;Logan, Barry K.
通讯作者：
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2.5
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Stove, Christophe P.
影响因子：
2.5
作者：
Krotulski, Alex J.;Papsun, Donna M.;Logan, Barry K.
通讯作者：
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