Xylazine Pharmacokinetics in Patients Testing Positive for Fentanyl and Xylazine.

IF 7.1 2区医学 Q1 MEDICAL LABORATORY TECHNOLOGY

Clinical chemistry Pub Date : 2024-11-20 DOI:10.1093/clinchem/hvae163

Yanchun Lin, Christopher W Farnsworth, Vahid Azimi, David B Liss, Michael E Mullins, Bridgit O Crews

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引用次数: 0

Abstract

Background: The increasing prevalence of xylazine in the illicit drug supply is a growing concern for major health consequences in individuals who use fentanyl mixed with xylazine, but limited data are available regarding the pharmacokinetics of xylazine in humans.

Methods: Xylazine was quantified in serial remnant plasmas collected from 28 patients starting at the initial patient encounter and continuing for up to 52 h from presentation, using LC-MS/MS to calculate the terminal half-life for xylazine. Xylazine metabolites were identified by product ion scanning, and multiple reaction monitoring was used to estimate the relative abundance of xylazine metabolites in 74 collected plasma samples.

Results: The median terminal half-life for xylazine was calculated to be 12.0 h (range: 5.9-20.8). Oxo-xylazine and sulfone-xylazine metabolites were detected in all plasma specimens that contained xylazine.

Conclusions: The half-life of xylazine in humans is longer than previously observed in animal studies, which furthers the current understanding of the expected duration of effects in individuals who use fentanyl mixed with xylazine and the window of detection. Both oxo-xylazine and sulfone-xylazine appear to circulate in plasma for as long as xylazine.

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芬太尼和赛拉嗪检测呈阳性患者的赛拉嗪药代动力学。

背景：非法药物供应中的异丙嗪越来越普遍，人们越来越担心使用与异丙嗪混合的芬太尼会对个人健康造成重大影响，但有关异丙嗪在人体中的药代动力学的数据却很有限：使用 LC-MS/MS 对从 28 名患者中收集的连续残余血浆中的恶嗪进行定量，从患者初次就诊开始，持续到就诊后的 52 小时，计算恶嗪的终末半衰期。通过产物离子扫描确定了赛拉嗪代谢物，并使用多重反应监测估算了 74 份收集的血浆样本中赛拉嗪代谢物的相对丰度：结果：据计算，恶嗪的中位终末半衰期为 12.0 小时（范围：5.9-20.8）。在所有含有恶嗪的血浆样本中都检测到了恶嗪和砜类恶嗪代谢物：人类体内的恶嗪半衰期长于之前在动物实验中观察到的时间，这进一步加深了目前对使用与恶嗪混合的芬太尼的个体的预期效应持续时间和检测窗口的理解。氧化恶嗪和磺酮恶嗪在血浆中的循环时间似乎与恶嗪一样长。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical chemistry 医学-医学实验技术

CiteScore

11.30

自引率

4.30%

发文量

212

审稿时长

1.7 months

期刊介绍： Clinical Chemistry is a peer-reviewed scientific journal that is the premier publication for the science and practice of clinical laboratory medicine. It was established in 1955 and is associated with the Association for Diagnostics & Laboratory Medicine (ADLM). The journal focuses on laboratory diagnosis and management of patients, and has expanded to include other clinical laboratory disciplines such as genomics, hematology, microbiology, and toxicology. It also publishes articles relevant to clinical specialties including cardiology, endocrinology, gastroenterology, genetics, immunology, infectious diseases, maternal-fetal medicine, neurology, nutrition, oncology, and pediatrics. In addition to original research, editorials, and reviews, Clinical Chemistry features recurring sections such as clinical case studies, perspectives, podcasts, and Q&A articles. It has the highest impact factor among journals of clinical chemistry, laboratory medicine, pathology, analytical chemistry, transfusion medicine, and clinical microbiology. The journal is indexed in databases such as MEDLINE and Web of Science.