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      The use of lateral flow immunoassays for the detection of fentanyl in seized drug samples and postmortem urine

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          An assessment of the limits of detection, sensitivity and specificity of three devices for public health-based drug checking of fentanyl in street-acquired samples

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            Clinical pharmacokinetics of alfentanil, fentanyl and sufentanil. An update.

            Alfentanil, fentanyl and sufentanil are synthetic opioid analgesics acting at specific opioid receptors. These opioids are widely used as analgesics to supplement general anaesthesia for various surgical procedures or as primary anaesthetic agents in very high doses during cardiac surgery. Fentanyl and sufentanil especially are administered via infusion for long term analgesia and sedation in intensive care patients. Opioid analgesics are mainly administered using the intravenous route. However, other techniques of administration, including epidural, intrathecal, transdermal and intranasal applications, have been demonstrated. Important pharmacokinetic differences between alfentanil, fentanyl and sufentanil have been shown in many reports. Alfentanil has the most rapid analgesic onset and time to peak effect as well as the shortest distribution and elimination half-lives. The volume of distribution and total body clearance of this agent are smaller when compared with those of fentanyl and sufentanil. The pharmacokinetics of the opioid analgesics can be affected by several factors including patient age, plasma protein content, acid-base status and cardiopulmonary bypass, but not significantly by renal insufficiency or compensated hepatic dysfunction. In addition, pharmacokinetic properties can be influenced by changes in hepatic blood flow and administration of drug combinations which compete for the same plasma protein carrier or metabolising pathway. Although comparing specific pharmacokinetic parameters such as half-lives is deeply entrenched in the literature and clinical practice, simply comparing half-lives is not a rational way to select an opioid for specific requirements. Using pharmacokinetic-pharmacodynamic models, computer simulations based on changes in the effect site opioid concentration or context-sensitive half-times seem to be extremely useful for selecting an opioid on a more rational basis.
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              Increased Presence of Fentanyl in Cocaine-Involved Fatal Overdoses: Implications for Prevention

              After remaining stable from 2010 to 2014, the  rate of cocaine-involved overdose death increased sharply from 2015 to 2016. This study aims to determine the contribution of opioids, and fentanyl in particular, to the increase in cocaine-involved overdose death from 2015 to 2016. Using New York City death certificate data linked to medical examiner toxicology data, we identified all overdose deaths where post-mortem toxicology results were positive for cocaine from 2010 to 2016. We analyzed cocaine-involved overdose deaths by co-occurring substances. Age-adjusted rates per 100,000 residents were calculated for 6-month intervals from 2010 to 2016. Data suggest that increased deaths involving opioids, specifically fentanyl, accounted for most of the increase in cocaine-involved deaths from 2015 to 2016.
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                Author and article information

                Journal
                Journal of Forensic Sciences
                J Forensic Sci
                Wiley
                0022-1198
                1556-4029
                March 2021
                December 04 2020
                March 2021
                : 66
                : 2
                : 758-765
                Affiliations
                [1 ]U.S. Army Combat Capabilities Development Command Chemical Biological Center Aberdeen Proving Ground MD USA
                [2 ]Department of Safety and Homeland Security Division of Forensic Science State of Delaware Wilmington DE USA
                [3 ]Anne Arundel County Forensic Services Anne Arundel County Police Millersville MD USA
                [4 ]Material Measurement Science Division National Institute of Standards & Technology Gaithersburg MD USA
                Article
                10.1111/1556-4029.14631
                cbac1bd9-5e64-482d-8b06-3a39fd0680f4
                © 2021

                http://onlinelibrary.wiley.com/termsAndConditions#vor

                http://doi.wiley.com/10.1002/tdm_license_1.1

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