口腔接触芬太尼透皮贴剂的并发症。
Complications of oral exposure to fentanyl transdermal delivery system patches.
机构信息
Division of Emergency Medicine, Weill Cornell Medical College, New York Presbyterian Hospital, 525 E. 68th St. M130, New York, NY 10065, USA.
出版信息
J Med Toxicol. 2010 Dec;6(4):443-7. doi: 10.1007/s13181-010-0092-8.
PURPOSE
Fentanyl is a synthetic opioid available therapeutically as an intravenous, transbucal, or transdermal preparation. It is also used as a drug of abuse through a variety of different methods, including the oral abuse of transdermal fentanyl patches. This is a series of patients with oral fentanyl patch exposure reported to our center and represents the first series of oral fentanyl patch exposures collected outside of the postmortem setting.
METHODS
In this series, we examined the New York Poison Control Center database for all cases of oral abuse of fentanyl reported between January 2000 and April 2008.
RESULTS
Twenty cases were reported, nine were asymptomatic or had symptoms of opioid withdrawal; 11 had symptoms of opioid intoxication. Eight patients were administered naloxone and all showed improvement in clinical status. Only one case resulted in a confirmed fatality-this patient had an orally adherent patch discovered at intubation.
CONCLUSIONS
Oral exposure may result in life-threatening toxicity. Patients should be closely assessed and monitored for the opioid toxidrome, and if symptomatic, should be managed with opioid antagonists and ventilatory support.
目的
芬太尼是一种合成阿片类药物，可通过静脉、经颊或经皮途径给药。它也被滥用，通过多种不同的方法，包括经口滥用透皮芬太尼贴片。这是一组在我们中心报告的口服芬太尼贴片暴露患者，代表了首次在死后环境之外收集的口服芬太尼贴片暴露系列。
方法
在该系列中，我们检查了纽约毒物控制中心数据库，以获取 2000 年 1 月至 2008 年 4 月期间报告的所有经口滥用芬太尼的病例。
结果
报告了 20 例，其中 9 例无症状或有阿片类药物戒断症状；11 例有阿片类药物中毒症状。8 例患者给予了纳洛酮，所有患者的临床状况均有所改善。只有一例导致确认死亡-该患者在插管时发现了一个附着在口腔上的贴片。
结论
口服暴露可能导致危及生命的毒性。应密切评估和监测阿片类药物中毒症状的患者，如果有症状，应使用阿片类拮抗剂和通气支持进行治疗。
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