New York University Langone Medical Center/Bellevue Hospital Center, New York City Poison Control Center, New York, NY 10016, USA.
Pediatrics. 2012 Dec;130(6):e1700-3. doi: 10.1542/peds.2012-1342. Epub 2012 Nov 5.
Buprenorphine is a partial μ-opioid receptor agonist that is approved for the treatment of opioid dependency. It is generally believed to be safer than methadone because of its ceiling effect on respiratory depression. As more adults in US households use buprenorphine, an increasing number of children are being exposed. We report a fatal exposure to buprenorphine in a small child that occurred after ingestion of a caretaker's buprenorphine/naloxone. Postmortem toxicology analysis showed free serum concentrations of 52 ng/mL and 39 ng/mL for buprenorphine and norbuprenorphine, respectively. No other drugs were detected. Autopsy did not find signs of injury or trauma. The theoretical safety provided by the ceiling effect in respiratory depression from buprenorphine may not apply to children, and buprenorphine may cause dose-dependent respiratory depression.
丁丙诺啡是一种部分μ-阿片受体激动剂，已被批准用于治疗阿片类药物依赖。由于其对呼吸抑制的封顶效应，一般认为它比美沙酮更安全。随着越来越多的美国家庭成年人使用丁丙诺啡，越来越多的儿童受到暴露。我们报告了一例因摄入看护者的丁丙诺啡/纳洛酮而导致的幼儿致命暴露于丁丙诺啡的病例。尸检毒理学分析显示，丁丙诺啡和去甲丁丙诺啡的游离血清浓度分别为 52ng/mL 和 39ng/mL。未检测到其他药物。尸检未发现损伤或创伤的迹象。丁丙诺啡在呼吸抑制方面提供的封顶效应的理论安全性可能不适用于儿童，并且丁丙诺啡可能会导致剂量依赖性呼吸抑制。
