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A 2017-2019 Update on Acute Intoxications and Fatalities from Illicit Fentanyl and Analogs.
Brunetti, Pietro; Pirani, Filippo; Carlier, Jeremy; Giorgetti, Raffaele; Busardò, Francesco Paolo; Lo Faro, Alfredo Fabrizio.
Afiliação
  • Brunetti P; Department of Excellence of Biomedical Sciences and Public Health, University "Politecnica delle Marche" of Ancona, Via Tronto 71, Ancona, Italy.
  • Pirani F; Department of Excellence of Biomedical Sciences and Public Health, University "Politecnica delle Marche" of Ancona, Via Tronto 71, Ancona, Italy.
  • Carlier J; Department of Excellence of Biomedical Sciences and Public Health, University "Politecnica delle Marche" of Ancona, Via Tronto 71, Ancona, Italy.
  • Giorgetti R; Department of Excellence of Biomedical Sciences and Public Health, University "Politecnica delle Marche" of Ancona, Via Tronto 71, Ancona, Italy.
  • Busardò FP; Department of Excellence of Biomedical Sciences and Public Health, University "Politecnica delle Marche" of Ancona, Via Tronto 71, Ancona, Italy.
  • Lo Faro AF; Department of Excellence of Biomedical Sciences and Public Health, University "Politecnica delle Marche" of Ancona, Via Tronto 71, Ancona, Italy.
J Anal Toxicol ; 45(6): 537-554, 2021 Jul 10.
Article em En | MEDLINE | ID: mdl-32860688
ABSTRACT
The aim of this review was to report the most recent cases of acute intoxication, fatalities and "driving under the influence" cases, involving illicit fentanyl and its newest analogs. When available, information on age, sex, circumstances of exposure, intoxication symptoms, cause of death (if applicable) and toxicology results from biological fluid testing was described. Scientific publications reporting fatalities or acute intoxications involving use of fentanyl derivatives were identified from PubMed, Scopus and institutional/governmental websites from January 2017 up to December 2019. The search terms, used alone and in combination, were as follows fentanyl, street fentanyl, analogs, compounds, derivatives, abuse, fatality, fatalities, death, toxicity, intoxication and adverse effects. When considered relevant, reports not captured by the initial search but cited in other publications were also included. Of the 2890 sources initially found, only 44 were suitable for the review. Emergent data showed that the most common analogs detected in biological samples and seized materials are acetylfentanyl, acrylfentanyl, butyrfentanyl, carfentanil, cyclopropylfentanyl, fluorofentanyl, 4-fluorobutyrfentanyl, 4-fluoroisobutyrfentanyl, furanylfentanyl, 2-methoxyacetylfentanyl, 3-methylfentanyl and ocfentanil. These compounds were frequently administered in association with other illicit substances, medicinal drugs and/or alcohol; patients and the victims often had a previous history of drug abuse. The trend of fentanyl analogs is rapidly evolving with illicit market fluctuations. Since information about potency and lethal dosage are frequently unknown, it is important to identify the new trends for further investigation on therapeutic use, toxicity and fatal doses, and implement public health measures. Recently marketed fentanyl analogs such as crotonylfentanyl and valerylfentanyl were not involved in intoxications to date, but should be carefully monitored. Many intoxications and fatalities might have gone unnoticed, and research efforts should focus on metabolite identification studies and the implementation of updated and comprehensive analytical methods.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Transtornos Relacionados ao Uso de Substâncias / Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos Tipo de estudo: Diagnostic_studies / Prognostic_studies Limite: Humans Idioma: En Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Transtornos Relacionados ao Uso de Substâncias / Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos Tipo de estudo: Diagnostic_studies / Prognostic_studies Limite: Humans Idioma: En Ano de publicação: 2021 Tipo de documento: Article