Fentanyl, fentanyl analogs and novel synthetic opioids: A comprehensive review

NEUROPHARMACOLOGY

卷:134

Review

Armenian, Patil¹  Vo, Kathy T.²  Barr-Walker, Jill³  Lynch, Kara L.⁴ 

[1] Univ Calif San Francisco Fresno, Dept Emergency Med, 155 N Fresno St, Fresno, CA 93701 USA

[2] Univ Calif San Francisco, Dept Emergency Med, Calif Poison Control Syst, San Francisco Div, UCSF Box 1369, San Francisco, CA 94143 USA

[3] Univ Calif San Francisco, 1001 Potrero Ave, San Francisco, CA 94110 USA

[4] Univ Calif San Francisco, Dept Lab Med, Clin Chem, 1001 Potrero Ave, San Francisco, CA 94110 USA

关键词: Opioid;    Synthetic opioids;    Fentanyl;    Fentanyl analog;    Carfentanil;    Naloxone;   

DOI  :  10.1016/j.neuropharm.2017.10.016

来源: Elsevier

【 摘 要 】

Deaths from opioid use are increasing in the US, with a growing proportion due to synthetic opioids. Until 2013, sporadic outbreaks of fentanyl and fentanyl analogs contaminating the heroin supply caused some deaths in heroin users. Since then, fentanyl has caused deaths in every state and fentanyl and its analogs have completely infiltrated the North American heroin supply. In 2014, the first illicit pills containing fentanyl, fentanyl analogs, and other novel synthetic opioids such as U-47700 were detected. These pills, which look like known opioids or benzodiazepines, have introduced synthetic opioids to more unsuspecting customers. As soon as these drugs are regulated by various countries, new compounds quickly appear on the market, making detection difficult and the number of cases likely underreported. Standard targeted analytical techniques such as GC-MS (gas chromatography mass spectrometry) and LC-MS/MS (liquid chromatography tandem mass spectrometry) can detect these drugs, but novel compound identification is aided by nontargeted testing with LC-HRMS (liquid chromatography high resolution mass spectrometry). Fentanyl, fentanyl analogs and other novel synthetic opioids are all full agonists of varying potencies at the-opioid receptor, leading to typical clinical effects of miosis and respiratory and central nervous system depression. Due to their high affinity for p-opioid receptors, larger doses of naloxone are required to reverse the effects than are commonly used. Synthetic opioids are an increasingly major public health threat requiring vigilance from multiple fields including law enforcement, government agencies, clinical chemists, pharmacists, and physicians, to name a few, in order to stem its tide. This article is part of the Special Issue entitled 'Designer Drugs and Legal Highs.' (C) 2017 Elsevier Ltd. All rights reserved.

【 授权许可】

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