Butyrfentanyl overdose resulting in diffuse alveolar hemorrhage

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 uncertai...

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Bibliographic Details
Published in:Pediatrics (Evanston) 2015-03, Vol.135 (3), p.e740-e743
Main Authors: Cole, Jon B, Dunbar, John F, McIntire, Sarah A, Regelmann, Warren E, Slusher, Tina M
Format: Article
Language:English
Subjects:
Analgesics, Opioid - poisoning
Bronchoscopy
Case studies
Complications and side effects
Diagnosis, Differential
Drug overdose
Drug Overdose - complications
Drugs
Fentanyl
Fentanyl - analogs & derivatives
Fentanyl - poisoning
Hemoptysis - diagnosis
Hemoptysis - etiology
Hemorrhage
Humans
Male
Overdose
Pediatrics
Prescription drugs
Pulmonary Alveoli - blood supply
Radiography, Thoracic
Respiratory diseases
Risk factors
Uncertainty
Young Adult
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Summary: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.
ISSN:0031-4005
1098-4275
DOI:10.1542/peds.2014-2878