In 20 out of 266 patients who presented to the emergency department after an opioid overdose 19/20 (95%) tested positive for fentanyl. Most required no venipuncture and were ineligible for the study. Was there a correlation between naloxone dose equivalents and blood fentanyl concentrations?
No. But there was a positive correlation between naloxone dose in the group that was also found with sedative-hypnotics in their blood. In these participants, the fentanyl concentration was lower compared to those without a sedative-hypnotic detected.
Krotulski AJ, Chapman BP, Marks SJ, Ontiveros ST, Devin-Holcombe K, Fogarty MF, Trieu H, Logan BK, Merchant RC, Babu KM. Sentanyl: a comparison of blood fentanyl concentrations and naloxone dosing after non-fatal overdose. Clin Toxicol (Phila). 2021 Jul 19:1-8. doi: 10.1080/15563650.2021.1948558. Epub ahead of print. PMID: 34278904.
Submitted by: Kirk Cumpston, DO, FAACT on behalf of The Medical Toxicology Fellowship, Virginia Commonwealth University