Department of Emergency Medicine, Hennepin Regional Poison Center,
Transitional Residency at Hennepin County Medical Center, Minneapolis, Minnesota;
Pediatrics. 2015 Mar;135(3):e740-3. doi: 10.1542/peds.2014-2878.
Butyrfentanyl is a potent short-acting opioid and a fentanyl analog with uncertain clinical effects. A review of the literature reveals no human case reports of butyrfentanyl overdose. As the use of analog and synthetic drugs continues to increase, clinicians are often faced with tremendous uncertainty when they encounter patients exposed to these synthetic drugs. We describe, to our knowledge, the first case of a butyrfentanyl overdose that resulted in clinically significant hemoptysis, acute lung injury, hypoxic respiratory failure, and diffuse alveolar hemorrhage. Complicating this case was a false-positive urine drug screen for fentanyl. Clinicians who encounter fentanyl exposures should be aware they may in fact be dealing with butyrfentanyl. As little is known of butyrfentanyl and our patient suffered a significant pulmonary hemorrhage, those who encounter butyrfentanyl exposures should monitor for hemorrhagic complications.
丁酰芬太尼是一种强效的短效阿片类药物和芬太尼类似物，其临床效果尚不确定。文献回顾显示，没有人类丁酰芬太尼过量的病例报告。随着类似物和合成药物的使用不断增加，临床医生在遇到接触这些合成药物的患者时，往往会面临巨大的不确定性。据我们所知，我们描述了首例丁酰芬太尼过量导致临床显著咯血、急性肺损伤、低氧性呼吸衰竭和弥漫性肺泡出血的病例。使这个病例复杂化的是芬太尼尿液药物筛查呈假阳性。遇到芬太尼暴露的临床医生应该意识到，他们实际上可能正在处理丁酰芬太尼。由于对丁酰芬太尼知之甚少，而且我们的患者发生了严重的肺出血，因此遇到丁酰芬太尼暴露的人应该监测出血并发症。
