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Xylazine poisoning: a systematic review.
Noah S Ball1, Brittany M Knable1, Taylor A Relich1
1Duquesne University School of Pharmacy, Pittsburgh, PA.
Clinical Toxicology (Philadelphia, Pa.)
|April 20, 2022
Summary
Human exposure to xylazine, a veterinary sedative, is increasing. Common symptoms include low blood pressure and heart rate, but severe outcomes like death can occur. Further research is needed for effective treatment.
Area of Science:
- Veterinary medicine
- Human toxicology
- Pharmacology
Background:
- Xylazine is an alpha-2-adrenergic agonist used in veterinary medicine for sedation and pain relief.
- Despite not being FDA-approved for human use, reports indicate a rise in human xylazine exposures.
- Understanding the clinical presentation, management, and outcomes of human xylazine exposure is crucial.
Purpose of the Study:
- To systematically review and synthesize existing evidence on human xylazine exposure.
- To focus on the clinical manifestations, treatment strategies, and patient outcomes associated with xylazine exposure in humans.
Main Methods:
- A systematic literature review was conducted using PubMed, Embase, and Scopus databases up to September 9, 2021.
- Abstracts from emergency medicine and toxicology conferences (2011-2021) were also searched.
- Clinical reports of human xylazine exposure were included, excluding animal, in vitro, and laboratory studies.
Main Results:
- A total of 17 articles and 2 abstracts, detailing 98 patients across nine countries from 1979-2020, were identified.
- The primary routes of exposure were unintentional incidents and intentional misuse or abuse.
- Commonly reported symptoms included hypotension, bradycardia, drowsiness, and lethargy; apnea and death were less frequent.
Conclusions:
- Human xylazine exposure is an emerging public health concern, particularly in prehospital and emergency settings.
- Current evidence does not support a standardized treatment algorithm for xylazine exposure.
- Further research is essential to develop effective management strategies for affected patients.
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