Xylazine – from a veterinary medicine to a deadly drug of abuse

Xylazine, a potent α2-adrenergic receptor agonist, is used exclusively in veterinary medicine for its sedative, analgesic and muscle-relaxant effects. The drug is used in dogs, cats, rabbits, horses, cattle, sheep, goats, cervids, birds and laboratory animals for sedation and also to prepare for the...

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Main Author: Jolanta Barbara Zawilska
Format: Article
Language:Polish
Published: Polish Pharmaceutical Society 2023-11-01
Series:Farmacja Polska
Subjects:
Online Access:https://www.ptfarm.pl/download/?file=File%2FFarmacja+Polska%2F2023%2F7%2F02_OG_Ksylazyna_n.pdf
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author Jolanta Barbara Zawilska
author_facet Jolanta Barbara Zawilska
author_sort Jolanta Barbara Zawilska
collection DOAJ
description Xylazine, a potent α2-adrenergic receptor agonist, is used exclusively in veterinary medicine for its sedative, analgesic and muscle-relaxant effects. The drug is used in dogs, cats, rabbits, horses, cattle, sheep, goats, cervids, birds and laboratory animals for sedation and also to prepare for the induction of general anesthesia before surgery. Xylazine has a low therapeutic index. Exceeding the therapeutic dose two or three times may lead to the animal falling or dying due to respiratory and circulatory depression. Although the substance has never been approved for the therapeutic use in humans, over the last decade xylazine (aka “tranq” from tranquilizer) has become popular in the street drug market as an adulterant of heroin and illicit fentanyl (“tranq dope”); less frequently fentanyl analogues or new synthetic opioids that are not derivatives of fentanyl. In media reports we can also find the term "zombi drug" for xylazine. After opioids, stimulants, cannabinoids and benzodiazepines were the most common drug classes detected in conjunction with xylazine in both non-fatal and fatal intoxication cases. According to many users, xylazine may prolong the euphoric and sedative effects of fentanyl and delay the onset of withdrawal symptoms. In turn, the combined use of xylazine with cocaine or amphetamines is intended to weaken the psychostimulant effects of these drugs and symptoms of withdrawal syndrome. Use of xylazine is reported to be associated with serious cardiovascular deterioration, psychiatric and neurological symptoms, respiratory depression, hyperglycemia, and severe festering skin ulcers of the limbs with subcutaneous tissue necrosis and osteomyelitis. Xylazine is not an opioid, thus although opioids and xylazine cause similar respiratory symptoms, naloxone will not reverse the effects of xylazine overdose. Due to the fact that in Poland there is more and more media information warning about the deadly threat posed by the use of xylazine, especially xylazine combined with opioid drugs, this review is aimed to present pharmacodynamic and pharmacokinetic properties of xylazine, its toxic effects, including those in which the substance was used as adulterant of illegal drugs of abuse. Finally, treatment of xylazine overdoses and therapeutical strategies aimed to management withdrawal symptoms are discussed.
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spelling doaj.art-f90cba214f4245ddb474a907b7fe43022023-12-28T12:27:53ZpolPolish Pharmaceutical SocietyFarmacja Polska0014-82612023-11-0179739740210.32383/farmpol/174418174418Xylazine – from a veterinary medicine to a deadly drug of abuseJolanta Barbara Zawilska0https://orcid.org/0000-0002-3696-2389Zakład Farmakodynamiki, Uniwersytet Medyczny w Łodzi, PolskaXylazine, a potent α2-adrenergic receptor agonist, is used exclusively in veterinary medicine for its sedative, analgesic and muscle-relaxant effects. The drug is used in dogs, cats, rabbits, horses, cattle, sheep, goats, cervids, birds and laboratory animals for sedation and also to prepare for the induction of general anesthesia before surgery. Xylazine has a low therapeutic index. Exceeding the therapeutic dose two or three times may lead to the animal falling or dying due to respiratory and circulatory depression. Although the substance has never been approved for the therapeutic use in humans, over the last decade xylazine (aka “tranq” from tranquilizer) has become popular in the street drug market as an adulterant of heroin and illicit fentanyl (“tranq dope”); less frequently fentanyl analogues or new synthetic opioids that are not derivatives of fentanyl. In media reports we can also find the term "zombi drug" for xylazine. After opioids, stimulants, cannabinoids and benzodiazepines were the most common drug classes detected in conjunction with xylazine in both non-fatal and fatal intoxication cases. According to many users, xylazine may prolong the euphoric and sedative effects of fentanyl and delay the onset of withdrawal symptoms. In turn, the combined use of xylazine with cocaine or amphetamines is intended to weaken the psychostimulant effects of these drugs and symptoms of withdrawal syndrome. Use of xylazine is reported to be associated with serious cardiovascular deterioration, psychiatric and neurological symptoms, respiratory depression, hyperglycemia, and severe festering skin ulcers of the limbs with subcutaneous tissue necrosis and osteomyelitis. Xylazine is not an opioid, thus although opioids and xylazine cause similar respiratory symptoms, naloxone will not reverse the effects of xylazine overdose. Due to the fact that in Poland there is more and more media information warning about the deadly threat posed by the use of xylazine, especially xylazine combined with opioid drugs, this review is aimed to present pharmacodynamic and pharmacokinetic properties of xylazine, its toxic effects, including those in which the substance was used as adulterant of illegal drugs of abuse. Finally, treatment of xylazine overdoses and therapeutical strategies aimed to management withdrawal symptoms are discussed.https://www.ptfarm.pl/download/?file=File%2FFarmacja+Polska%2F2023%2F7%2F02_OG_Ksylazyna_n.pdfxylazinefentanylheroincocaineintoxicationsaddiction
spellingShingle Jolanta Barbara Zawilska
Xylazine – from a veterinary medicine to a deadly drug of abuse
Farmacja Polska
xylazine
fentanyl
heroin
cocaine
intoxications
addiction
title Xylazine – from a veterinary medicine to a deadly drug of abuse
title_full Xylazine – from a veterinary medicine to a deadly drug of abuse
title_fullStr Xylazine – from a veterinary medicine to a deadly drug of abuse
title_full_unstemmed Xylazine – from a veterinary medicine to a deadly drug of abuse
title_short Xylazine – from a veterinary medicine to a deadly drug of abuse
title_sort xylazine from a veterinary medicine to a deadly drug of abuse
topic xylazine
fentanyl
heroin
cocaine
intoxications
addiction
url https://www.ptfarm.pl/download/?file=File%2FFarmacja+Polska%2F2023%2F7%2F02_OG_Ksylazyna_n.pdf
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