Alteration in the arrhythmogenic dose of epinephrine (ADE) following xylazine administration to halothane‐anesthetized dogs

Tranquilli, William J.; Jc, Thurmon; Gj, Benson; Davis, Lloyd

doi:10.1111/j.1365-2885.1986.tb00030.x

Cited by 21 publications

(4 citation statements)

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“…Several studies and case reports emphasize the cardiac complications that can arise from Xylazine use, such as biventricular systolic failure, valvular dysfunction, and myocardial necrosis and fibrosis [55][56][57]. In some cases, clinical treatment with nifedipine has been found effective in managing these cardiac complications [58]. In addition to its impact on the cardiovascular system, Xylazine has been linked to pulmonary issues.…”

Section: Hemodynamic Effectsmentioning

confidence: 99%

Xylazine in the Opioid Epidemic: A Systematic Review of Case Reports and Clinical Implications

Ayub¹,

Parnia²,

Poddar³

et al. 2023

Cureus

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Introduction and objectives: The opioid overdose epidemic is exacerbated by the emergence of Xylazine as an illicit drug adulterant. Xylazine, a veterinary sedative, can potentiate opioid effects while also causing toxic and potentially fatal side effects. This systematic review aims to assess the impact of Xylazine use and overdoses within the opioid epidemic context. Method: A systematic search was conducted following PRISMA guidelines to identify relevant case reports, and case series related to Xylazine use. A comprehensive literature search included databases like Web of Science, PubMed, Embase, and Google Scholar, utilizing keywords and Medical Subject Headings (MeSH) terms related to Xylazine. Thirty-four articles met the inclusion criteria for this review. Results: Intravenous (IV) administration was a common route for Xylazine use among various methods, including subcutaneous (SC), intramuscular (IM), and inhalation, with overall doses ranging from 40 mg to 4300 mg. The average dose in fatal cases was 1,200 mg, compared to 525 mg in non-fatal cases. Concurrent administration of other drugs, primarily opioids, occurred in 28 cases (47.5%). Intoxication was identified as a notable concern in 32 out of 34 studies, and treatments varied, with the majority experiencing positive outcomes. Withdrawal symptoms were documented in one case study, but the low number of cases with withdrawal symptoms may be attributed to factors such as a limited number of cases or individual variation. Naloxone was administered in eight cases (13.6%), and all patients recovered, although it should not be misconstrued as an antidote for Xylazine intoxication. Of the 59 cases, 21 (35.6%) resulted in fatal outcomes, with 17 involving Xylazine use in conjunction with other drugs. The IV route was a common factor in six out of the 21 fatal cases (28.6%). Conclusion: This review highlights the clinical challenges associated with Xylazine use and its co-administration with other substances, particularly opioids. Intoxication was identified as a major concern, and treatments varied across the studies, including supportive care, naloxone, and other medications. Further research is needed to explore the epidemiology and clinical implications of Xylazine use. Understanding the motivations and circumstances leading to Xylazine use, as well as its effects on users, is essential for developing effective psychosocial support and treatment interventions to address this public health crisis.

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Section: Hemodynamic Effectsmentioning

confidence: 99%

Xylazine in the Opioid Epidemic: A Systematic Review of Case Reports and Clinical Implications

Ayub¹,

Parnia²,

Poddar³

et al. 2023

Cureus

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“…Values are reported as means & standard error. The ADE (pg/kg) for H, HG, I, and IG were 1.53 f 0.08, 3.37 f 0.46, 1.6 1 t 0.2 1, and > 15.00, respectively. Heart rates (HRs) (beats/min) and systolic pressures (mmHg) at the time of arrhythmia formation for H, HG, I, and 1G were (60.3 f 4.0 and 142.0 +.…”

mentioning

confidence: 93%

Influence of Cholinergic Blockade on the Development of Epinephrine‐Induced Ventricular Arrhythmias in Halothane‐ and Isoflurane‐Anesthetized Dogs

et al. 1994

Veterinary Surgery

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The arrhythmogenic effects of anesthetic drugs are assessed using the arrhythmogenic dose of epinephrine (ADE) model. The purpose of this study was to determine the influence of cholinergic blockade (CB) produced by glycopyrrolate (G) on ADE in 1.5 minimum alveolar concentration (MAC) halothane (H)- and isoflurane (I)-anesthetized dogs. Eight dogs (weighing between 12.5 and 21.5 kg) were randomly assigned to four treatment groups (H, HG, I, and IG) and each treatment was replicated three times. Anesthesia was induced and maintained with H (1.31%, end-tidal [ET]) or I (1.95%, ET) in oxygen. Ventilation was controlled (carbon dioxide [PCO2] 35 to 40 mmHg, ET). G was administered 10 minutes before ADE determination at a dose of 22 microgram/kg (11 microgram/kg, intravenous [IV] and 11 micrograms/kg, intramuscular [IM]). The ADE was determined by IV infusion of epinephrine at sequentially increasing rates of 1.0, 2.5, and 5.0 micrograms/kg/min; and defined as the total dose of epinephrine producing at least four ectopic ventricular contractions (EVCs) within 15 seconds during a 3-minute infusion and up to 1 minute after the end of the infusion. Total dose was calculated as the product of infusion rate and time to arrhythmia. Data were analyzed using a randomized complete block analysis of variance. When significant (P < .05) F values were found a least significant difference test was used to compare group means. Values are reported as means +/- standard error. The ADE (micrograms/kg) for H, HG, I, and IG were 1.53 +/- 0.08, 3.37 +/- 0.46, 1.61 +/- 0.21, and > 15.00, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

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“…The oxygen requirements of a horse must be increased by the work necessary for it to regain its feet, but whether residual medetomidine limited this pony's normal physiological responses to the additional requirement is not known. Another possible cause of a cardiac arrest when an animal is recovering from anaesthesia could be adrenaline‐induced arrhythmias (Tranquilli and others 1986). Hayashi and others (1991) have shown that in dogs dexmedetomidine reduces the risk of this occurring under halothane anaesthesia.…”

Section: Discussionmentioning

confidence: 99%

Minimal alveolar concentration of desflurane in combination with an infusion of medetomidine for the anaesthesia of ponies

Bettschart‐Wolfensberger

Jaggin-Sdimucker

Lendl

et al. 2001

Veterinary Record

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The minimum alveolar concentration of desflurane when combined with a continuous infusion of medetomidine at 3.5 microg/kg/hour was measured in seven ponies. Anaesthesia was induced with medetomidine (7 microg/kg intravenously) followed by ketamine (2 mg/kg intravenously) and maintained with desflurane in oxygen. The infusion of medetomidine was started 20 minutes after the induction of anaesthesia. The electrical test stimulus was applied at the coronary band (50 V, 10 ms bursts at 5 Hz for one minute), and heart rates and rhythms, arterial blood pressures, and arterial blood gas tensions were measured at intervals, just before the application of the stimulus. The mean (sd) minimum alveolar concentration of desflurane was 5.3 (1.04) per cent (range 3.2 to 6.4 per cent), 28 per cent less than the previously published value for desflurane alone after the induction of anaesthesia with xylazine and ketamine. The cardiopulmonary parameters remained stable throughout the period of anaesthesia. The mean (sd) time taken by the ponies to stand after the administration of desflurane ceased was 16.5 (6.17) (range 5.8 to 26) minutes, and the quality of recovery was good or excellent. However, one pony died shortly after standing; a postmortem examination revealed that it had chronic left atrial dilatation.

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Alteration in the arrhythmogenic dose of epinephrine (ADE) following xylazine administration to halothane‐anesthetized dogs

Cited by 21 publications

References 20 publications

Xylazine in the Opioid Epidemic: A Systematic Review of Case Reports and Clinical Implications

Xylazine in the Opioid Epidemic: A Systematic Review of Case Reports and Clinical Implications

Influence of Cholinergic Blockade on the Development of Epinephrine‐Induced Ventricular Arrhythmias in Halothane‐ and Isoflurane‐Anesthetized Dogs

Minimal alveolar concentration of desflurane in combination with an infusion of medetomidine for the anaesthesia of ponies

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