Xylazine toxicity: Difference between revisions
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*Veterinary sedative, anesthetic, analgesic, and muscle relaxant | *Veterinary sedative, anesthetic, analgesic, and muscle relaxant | ||
*Human drug of abuse, usually as drug adulterant without the knowledge of people who use these drugs | *Human drug of abuse, usually as drug adulterant without the knowledge of people who use these drugs | ||
**<u>Not</u> an opioid, but often combined with opioids and increases the risk of overdose and death | **<u>Not</u> an opioid, but often combined with [[opioids]] and increases the risk of overdose and death | ||
**Associated with complex skin infections when injected | **Associated with complex [[skin infections]] when injected | ||
==Clinical Features== | ==Clinical Features== | ||
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==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Sedatve/hypnotic toxicity types}} | {{Sedatve/hypnotic toxicity types}} | ||
{{Symptomatic bradycardia}} | |||
==Evaluation== | ==Evaluation== | ||
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==See Also== | ==See Also== | ||
*[[Sedative/hypnotic toxicity]] | |||
==External Links== | ==External Links== | ||
Latest revision as of 15:45, 15 March 2023
Background
- Also known as "Tranq"
- Analogue of clonidine and agonist at alpha 2 adrenergic receptor[1]
- Veterinary sedative, anesthetic, analgesic, and muscle relaxant
- Human drug of abuse, usually as drug adulterant without the knowledge of people who use these drugs
- Not an opioid, but often combined with opioids and increases the risk of overdose and death
- Associated with complex skin infections when injected
Clinical Features
- Bradycardia
- Respiratory depression
- Hypotension
Differential Diagnosis
Sedative/hypnotic toxicity
- Absinthe
- Barbiturates
- Benzodiazepines
- Chloral hydrate
- Gamma hydroxybutyrate (GHB)
- Baclofen toxicity
- Opioids
- Toxic alcohols
- Xylazine toxicity
Symptomatic bradycardia
- Cardiac
- Inferior MI (involving RCA)
- Sick sinus syndrome
- Neurocardiogenic/reflex-mediated
- Increased ICP
- Vasovagal reflex
- Hypersensitive carotid sinus syndrome
- Intra-abdominal hemorrhage (i.e. ruptured ectopic)
- Metabolic/endocrine/environmental
- Hyperkalemia
- Hypothermia (Osborn waves on ECG)
- Hypothyroidism
- Hypoglycemia (neonates)
- Toxicologic
- Infectious/Postinfectious
- Other
Evaluation
- Evaluate for alternate etiologies
- Clinical diagnosis
- Consider collecting serum toxicology tests specifically for xylazine, if available (for public health reasons; does not affect acute management)
Management
- Supportive: address airway/respiratory drive/blood pressure, atropine for bradycardia
- Consider administration of naloxone due to high likelihood that opioids are also present (does not directly affect xylazine toxicity)
Disposition
- Admit if not back to baseline