Protracted renal clearance of fentanyl in persons with opioid use disorder.
Protracted renal clearance of fentanyl in persons with opioid use disorder.
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DOI：
10.1016/j.drugalcdep.2020.108147
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发表时间：
2020-09-01
影响因子：
4.2
通讯作者：
Strain EC
中科院分区：
文献类型：
--
作者：
Huhn AS;Hobelmann JG;Oyler GA;Strain EC
美国的非法阿片类药物供应越来越多地掺杂芬太尼。因此，阿片类药物使用障碍（OUD）患者可能经常暴露于芬太尼，然而，重复芬太尼暴露的药代动力学尚未得到很好的理解。目前的研究旨在量化OUD患者住院治疗时芬太尼的肾脏清除率。参加28天住院治疗计划的参与者（N=12）如果在摄入时芬太尼检测呈阳性，则被招募。每2-3天收集一次尿样，并通过液相色谱质谱法（LC-MS）定量检测芬太尼、去甲芬太尼和肌酐。芬太尼清除率定义为自末次非法使用阿片类药物以来的时间以及末次阳性和首次阴性芬太尼尿液筛查之间的中位时间。参与者的平均和标准差（SD）年龄为28.9（11.0），67%为男性，83%为白色。芬太尼和去甲芬太尼清除的平均（SD）时间分别为7.3（4.9）和13.3（6.9）天。一名参与者在最后一次使用后继续对芬太尼检测阳性19天，对去甲芬太尼检测阳性26天，并且在没有对去甲芬太尼检测阴性的情况下离开治疗。OUD患者的芬太尼清除率明显长于其他短效阿片类药物的典型2-4天清除率。这项研究的结果可能解释了最近关于使用芬太尼的人难以进行丁丙诺啡诱导的报道，并指出需要更好地了解经常使用芬太尼的人在阿片类药物戒断的背景下芬太尼的药代动力学。
The illicit opioid supply in the U.S. is increasingly adulterated with fentanyl. As such, persons with opioid use disorder (OUD) may be regularly exposed to fentanyl, however, the pharmacokinetics of repeated fentanyl exposure are not well understood. The current study aimed to quantify renal clearance of fentanyl in OUD patients presenting to residential treatment. Participants (N=12) who presented to a 28-day residential treatment program were enrolled if they tested positive for fentanyl at intake. Urine samples were collected every 2–3 days and were quantitatively tested for fentanyl, norfentanyl, and creatinine via liquid chromatography mass spectrometry (LC-MS). Fentanyl clearance was defined as the time since last illicit opioid use and the median time between last positive and first negative fentanyl urine screen. Participants had a mean and standard deviation (SD) age of 28.9 (11.0), were 67% male, and 83% white. The mean (SD) time for fentanyl and norfentanyl clearance was 7.3 (4.9) and 13.3 (6.9) days, respectively. One participant continued to test positive for fentanyl for 19 days and norfentanyl for 26 days following their last use, and left treatment without testing negative for norfentanyl. Fentanyl clearance in persons with OUD is considerably longer than the typical 2–4 day clearance of other short-acting opioids. The findings of this study might explain recent reports of difficulty in buprenorphine inductions for persons who use fentanyl, and point to a need to better understand the pharmacokinetics of fentanyl in the context of opioid withdrawal in persons who regularly use fentanyl.
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影响因子：
4.2
作者：
Hayashi K;Milloy MJ;Lysyshyn M;DeBeck K;Nosova E;Wood E;Kerr T
通讯作者：
Kerr T
影响因子：
8.8
作者：
VARVEL, JR;SHAFER, SL;STANSKI, DR
通讯作者：
STANSKI, DR
DOI：
10.1111/ajad.13069
发表时间：
2021-01
期刊：
The American journal on addictions
影响因子：
--
作者：
Antoine D;Huhn AS;Strain EC;Turner G;Jardot J;Hammond AS;Dunn KE
通讯作者：
Dunn KE
影响因子：
1.3
作者：
Smith, J. S.;Coetzee, J. F.;Mochel, J. P.
通讯作者：
Mochel, J. P.
影响因子：
3.7
作者：
ROY, SD;FLYNN, GL
通讯作者：
FLYNN, GL