涉及梅德托米丁与阿片类药物混合的过量服用 - 芝加哥,伊利诺伊州,2024年5月
MMWR. Morbidity and mortality weekly report
|May 1, 2025
概括
在芝加哥的阿片类药物过量中,发现动物镇静剂梅德托米丁与芬太尼混合在一起,导致严重的症状和对纳洛的反应不佳. 这标志着最大的梅德托米丁涉及过量剂量报告集群,突出需要广泛的公共卫生监测.
科学领域:
- 公共卫生 公共卫生
- 毒理学 毒理学 毒理学
- 紧急医疗 紧急医疗
背景情况:
- 梅德托米丁是一种非阿片类镇静剂,自2022年以来,在北美非法阿片类药物中被检测到.
- 非典型的过量服用症状促使对芝加哥的一批病例进行调查.
研究的目的:
- 在芝加哥调查和描述涉嫌涉及阿片类药物过量剂的爆发,涉及梅德托米丁.
- 为了确定与过量剂量集群相关的药物 adulterant 和患者人口统计数据.
主要方法:
- 多部门监控涉及医院,伊利诺伊州毒药中心和公共卫生部门.
- 对确诊,可能和疑似过量剂的案件调查和数据收集.
- 对药物样本和血液样本进行毒理学分析.
主要成果:
- 在芝加哥确定了12个确定的,26个可能的和140个涉及梅德托米丁的疑似过量服用.
- 在所有测试样本中,梅德托米丁与芬太尼混合;它是芝加哥药物供应中的新杂物.
- 确诊病例主要影响男性,非西班牙裔黑人或非裔美国人,年龄在45-64岁之间,表现为胸肌梗塞和纳洛反应不佳.
结论:
- 这次疫情代表了与美德托米丁有关的最大的过量剂量报告集群.
- 多部门监测对于检测非法毒品供应中的新型杂物至关重要.
- 对于所有疑似阿片类药物过量服用者来说,由于与阿片类药物经常同时发生,因此必须继续服用纳洛.
相关概念视频
Opioid Analgesics: Morphine and Other Natural Cogeners
Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
Opioid Analgesics: Synthetic and Semisynthetic Opioids
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
Parenteral Anesthetics: Overview
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
Drug Accumulation During Multiple Dosing: Repetitive IV Injections
Calculating drug dosage and accumulation in multiple-dose regimens is crucial for achieving therapeutic efficacy while avoiding toxicity. This involves determining the plasma drug concentrations over time to optimize dosing schedules. The principle of superposition is fundamental in this process, allowing for the prediction of drug concentration in plasma following multiple doses based on single-dose data.The principle of superposition asserts that the plasma concentration-time curves from...
Toxidromes: Clinical Features
Toxidromes are specific patterns of symptoms resulting from toxic substance exposure. They help in the identification and treatment of poisoning. The symptoms of each toxidrome group indicate poisoning by a certain class of chemicals or drugs.1. Sympathomimetic: Stimulates the sympathetic nervous system. Symptoms include agitation, increased heart rate (HR), blood pressure (BP), respiratory rate (RR), temperature, and pupil size. Drugs like cocaine and amphetamines, along with tremors and...
Pharmaceutical Poisoning: Potential Scenarios
Pharmaceutical poisoning can occur through various channels, impacting an estimated 2 million hospitalized patients in the U.S. annually with serious adverse drug responses. These scenarios encompass both therapeutic uses, such as drug toxicity, where even standard dosages can lead to severe central nervous system depression, and non-therapeutic exposures, including accidental ingestion by children, and environmental and occupational exposures.Unintentional poisonings often involve exploratory...


