1
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Christie JT, Bruce M, Pfitzer S, Laubscher L, Raath JP, Laurence M, Kellermann T. Validation of a LC-MS/MS method to simultaneously quantify thiafentanil and naltrexone in plasma for pharmacokinetic studies in wildlife. J Chromatogr B Analyt Technol Biomed Life Sci 2024; 1233:123990. [PMID: 38190774 DOI: 10.1016/j.jchromb.2023.123990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 12/15/2023] [Accepted: 12/26/2023] [Indexed: 01/10/2024]
Abstract
Thiafentanil is a popular opioid agonist that is fully reversed by administering naltrexone. This agonist-antagonist combination is administered to a wide variety of wildlife species for chemical immobilisation, however plasma concentrations for thiafentanil remain unreported. This report describes a method that was developed and validated using human plasma and cross-validated for the analysis of goat plasma. Samples were extracted using a simple protein precipitation and analysed using LC-MS/MS. The assay was validated over the calibration range 4.38 - 1120 ng/mL for thiafentanil and 15.63 - 4000 ng/mL for naltrexone. The mean inter-day accuracies for QCs prepared in human plasma (n = 18) ranged from 94.8 - 103.8 % for thiafentanil and 94.8 - 95.9 % for naltrexone with corresponding precisions of 3.4 - 7.9 % and 2.8 - 11.4 %, respectively. The mean accuracies for QCs prepared in goat plasma (n = 6) ranged from 89.0 - 100.5 % for thiafentanil and 89.0 - 98.0 % for naltrexone with the associated precisions ranging from 7.1 - 11.6 % and 4.8 - 12.3 %, respectively. Both analytes were stable on bench for six hours and for three freeze-thaw cycles. The impact of heat-inactivation, necessary for the inactivation of potential foot-and-mouth disease, on analyte stability, matrix effect and recovery were evaluated, and a correction factor was established to determine the original analyte concentrations. The method was applied to pharmacokinetic samples collected from goats. The use of goats as a model species provides the first insight into the plasma concentrations of thiafentanil.
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Affiliation(s)
- Judith T Christie
- School of Veterinary Medicine, Harry Butler Institute, Murdoch University, Murdoch, Western Australia, Australia.
| | - Mieghan Bruce
- School of Veterinary Medicine, Harry Butler Institute, Murdoch University, Murdoch, Western Australia, Australia
| | - Silke Pfitzer
- Department of Nature Conservation, Tshwane University of Technology, Pretoria, South Africa
| | - Liesel Laubscher
- Wildlife Pharmaceuticals, Rocky Drift, White River, South Africa
| | - Jacobus P Raath
- Wildlife Pharmaceuticals, Rocky Drift, White River, South Africa
| | - Michael Laurence
- School of Veterinary Medicine, Harry Butler Institute, Murdoch University, Murdoch, Western Australia, Australia
| | - Tracy Kellermann
- Division of Clinical Pharmacology, Department of Medicine, Stellenbosch University, South Africa
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2
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Wang J, Hu J, Liao P, Xue S, He S, Chen R, Zhao X, Liu W. The Synthesis of Biphasic Metabolites of Carfentanil. Molecules 2023; 28:7625. [PMID: 38005347 PMCID: PMC10674982 DOI: 10.3390/molecules28227625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 11/03/2023] [Accepted: 11/08/2023] [Indexed: 11/26/2023] Open
Abstract
Carfentanil is an ultra-potent synthetic opioid. The Russian police force used both carfentanil and remifentanil to resolve a hostage incident in Moscow. This reported use sparked an interest in the pharmacology and toxicology of carfentanil in the human body, and data on its metabolites were later published. However, there have been few studies on the synthesis of carfentanil metabolites, and biological extraction has also put forward large uncertainty in subsequent studies. The aim of the present study is to investigate the synthesis of biphasic metabolites that are unique to carfentanil. The purpose was to produce corresponding metabolites conveniently, quickly, and at low cost that can be used for comparison with published structures and to confirm the administration of carfentanil.
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Affiliation(s)
- Junchang Wang
- Shanghai Yuansi Standard Science and Technology Co., Ltd., Shanghai 200072, China
- Shanghai Key Laboratory of Crime Scene Evidence, Shanghai Research Institute of Criminal Science and Technology, Shanghai 200072, China
| | - Jianwen Hu
- Shanghai Yuansi Standard Science and Technology Co., Ltd., Shanghai 200072, China
- Shanghai Key Laboratory of Crime Scene Evidence, Shanghai Research Institute of Criminal Science and Technology, Shanghai 200072, China
| | - Pingyong Liao
- Shanghai Yuansi Standard Science and Technology Co., Ltd., Shanghai 200072, China
- Shanghai Key Laboratory of Crime Scene Evidence, Shanghai Research Institute of Criminal Science and Technology, Shanghai 200072, China
| | - Shang Xue
- Shanghai Yuansi Standard Science and Technology Co., Ltd., Shanghai 200072, China
- Shanghai Key Laboratory of Crime Scene Evidence, Shanghai Research Institute of Criminal Science and Technology, Shanghai 200072, China
| | - Shan He
- Shanghai Yuansi Standard Science and Technology Co., Ltd., Shanghai 200072, China
- Shanghai Key Laboratory of Crime Scene Evidence, Shanghai Research Institute of Criminal Science and Technology, Shanghai 200072, China
| | - Ruijia Chen
- Shanghai Yuansi Standard Science and Technology Co., Ltd., Shanghai 200072, China
- Shanghai Key Laboratory of Crime Scene Evidence, Shanghai Research Institute of Criminal Science and Technology, Shanghai 200072, China
| | - Xuejun Zhao
- Shanghai Yuansi Standard Science and Technology Co., Ltd., Shanghai 200072, China
- Shanghai Key Laboratory of Crime Scene Evidence, Shanghai Research Institute of Criminal Science and Technology, Shanghai 200072, China
| | - Wenbin Liu
- Shanghai Yuansi Standard Science and Technology Co., Ltd., Shanghai 200072, China
- Shanghai Key Laboratory of Crime Scene Evidence, Shanghai Research Institute of Criminal Science and Technology, Shanghai 200072, China
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3
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Tuet WY, Pierce SA, Conroy M, Vignola JN, Tressler J, diTargiani RC, McCranor BJ, Wong B. Metabolic clearance of select opioids and opioid antagonists using hepatic spheroids and recombinant cytochrome P450 enzymes. Pharmacol Res Perspect 2022; 10:e01000. [PMID: 36045607 PMCID: PMC9433823 DOI: 10.1002/prp2.1000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 07/22/2022] [Accepted: 07/23/2022] [Indexed: 11/21/2022] Open
Abstract
The opioid crisis is a pressing public health issue, exacerbated by the emergence of more potent synthetic opioids, particularly fentanyl and its analogs. While competitive antagonists exist, their efficacy against synthetic opioids is largely unknown. Furthermore, due to the short durations of action of current antagonists, renarcotization remains a concern. In this study, metabolic activity was characterized for fentanyl‐class opioids and common opioid antagonists using multiple in vitro systems, namely, cytochrome P450 (CYP) enzymes and hepatic spheroids, after which an in vitro‐in vivo correlation was applied to convert in vitro metabolic activity to predictive in vivo intrinsic clearance. For all substrates, intrinsic hepatic metabolism was higher than the composite of CYP activities, due to fundamental differences between whole cells and single enzymatic reactions. Of the CYP isozymes investigated, 3A4 yielded the highest absolute and relative metabolism across all substrates, with largely negligible contributions from 2D6 and 2C19. Comparative analysis highlighted elevated lipophilicity and diminished CYP3A4 activity as potential considerations for the development of more efficacious opioid antagonists. Finally, antagonists with a high degree of molecular similarity exhibited comparable clearance, providing a basis for structure‐metabolism relationships. Together, these results provide multiple screening criteria for early stage drug discovery involving opioid countermeasures.
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Affiliation(s)
- Wing Y Tuet
- Pharmaceutical Sciences Department, US Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, Maryland, USA
| | - Samuel A Pierce
- Pharmaceutical Sciences Department, US Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, Maryland, USA
| | - Matthieu Conroy
- Pharmaceutical Sciences Department, US Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, Maryland, USA
| | - Justin N Vignola
- Pharmaceutical Sciences Department, US Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, Maryland, USA
| | - Justin Tressler
- Pharmaceutical Sciences Department, US Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, Maryland, USA
| | - Robert C diTargiani
- Pharmaceutical Sciences Department, US Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, Maryland, USA
| | - Bryan J McCranor
- Pharmaceutical Sciences Department, US Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, Maryland, USA
| | - Benjamin Wong
- Pharmaceutical Sciences Department, US Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, Maryland, USA
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4
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Kong L, Walz AJ. Metabolism of the active carfentanil metabolite, 4-Piperidinecarboxylic acid, 1-(2-hydroxy-2-phenylethyl)-4-[(1-oxopropyl)phenylamino]-, methyl ester in vitro. Toxicol Lett 2022; 367:32-39. [PMID: 35835351 DOI: 10.1016/j.toxlet.2022.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 07/05/2022] [Accepted: 07/11/2022] [Indexed: 10/17/2022]
Abstract
Carfentanil, a µ-opioid receptor (MOR) agonist with an analgesic potency 10,000 times that of morphine, is extensively metabolized to norcarfentanil (M1), 4-Piperidinecarboxylic acid, 1-(2-hydroxy-2-phenylethyl)-4-[(1-oxopropyl)phenylamino]-, methyl ester (M0 in this article), and other low abundant metabolites in human hepatocytes and liver/lung microsomes. M0 possessed comparable MOR activity to carfentanil, and accounted for approximately 12 % of the total carfentanil metabolite formation in human liver microsomes (HLMs). Little is known about the subsequent elimination of M0. This study investigated its metabolic pathway in HLMs, separation and preliminary identification of metabolites by liquid chromatography-tandem mass spectrometry, and possible involvement of cytochrome P450 enzymes in M0 metabolism with kinetic analysis. M0 produced 9 metabolites via N-dealkylation (M1), oxidation (M3, M6-9), N-dealkylation followed by oxidation (M2 and M4), and glucuronidation (M5). Formation of the major metabolite M1 fitted typical Michaelis-Menten kinetics. Recombinant human CYP3A5 showed the highest activity toward M1 formation followed by CYP3A4 and CYP2C8, while M8 was primarily formed by CYP3A4 followed by CYP2C19 and CYP2C8. These findings reveal the main involvement of CYP3A5 and 3A4 in human hepatic elimination of M0 with a kinetic profile similar to carfentanil which may inform development of treatment protocols for carfentanil exposure.
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Affiliation(s)
- Li Kong
- Research and Technology Directorate, Combat Capabilities Development Command Chemical Biological Center, U. S. Army, Aberdeen Proving Ground, MD 21010-5424, United States.
| | - Andrew J Walz
- Research and Technology Directorate, Combat Capabilities Development Command Chemical Biological Center, U. S. Army, Aberdeen Proving Ground, MD 21010-5424, United States
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5
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Solbeck P, Woodall KL, Martin TL. Strategic Decision-Making by a Forensic Toxicology Laboratory in Response to an Emerging NPS: Detection, Quantitation and Interpretation of Carfentanil in Death Investigations in Ontario, Canada, July 2017 to June 2018. J Anal Toxicol 2021; 45:813-819. [PMID: 34166495 DOI: 10.1093/jat/bkab079] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 06/15/2021] [Accepted: 06/24/2021] [Indexed: 11/12/2022] Open
Abstract
The proliferation of novel psychoactive substances (NPS) and the current opioid epidemic creates challenges for a toxicology laboratory. Methods capable of detecting and quantitating emerging compounds must be established despite limited information on toxicologically relevant concentrations. This paper will (i) describe how a publicly funded forensic laboratory reacted to the emergence of carfentanil as a public safety concern and (ii) contribute to the existing forensic literature by presenting a series of deaths involving carfentanil between July 2017 and June 2018. The Centre of Forensic Sciences is the primary provider of forensic toxicology testing in medicolegal death investigations in the province of Ontario. When carfentanil was first identified in the illicit drug supply, routine screening methods used by this laboratory were not sufficiently sensitive to detect the drug at concentrations expected in blood samples. Previously validated, multi-target liquid chromatography-tandem mass spectrometry (LC-MS-MS) quantitative methods already in use by the laboratory did show improved detectability for carfentanil. Thus, an existing LC-MS-MS method was adapted to include carfentanil, achieving improved sensitivity while also providing quantitation in suspected drug-related deaths. This approach had the added benefit that the LC-MS-MS method selected for modification was used in all death investigations requiring toxicology analysis in Ontario, thereby providing an opportunity for surveillance. Using this method, 4,953 cases were analyzed with carfentanil detected at a concentration greater than the limit of detection (0.05 ng/mL) in 160 decedents. Postmortem blood carfentanil concentrations ranged from less than 0.1 to 9.2 ng/mL. Of the 160 carfentanil-positive cases, 156 were classified as either mixed drug toxicity or carfentanil overdose. The approach described enabled this laboratory to efficiently implement a quantitative test for carfentanil in all death investigations, providing a useful template for modifying existing methods when a new psychoactive substance becomes available in the population.
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Affiliation(s)
- Patricia Solbeck
- Quality Assurance Unit, Centre of Forensic Sciences, 25 Morton Shulman Ave, Toronto, ON M3M 0B1, Canada
| | - Karen L Woodall
- Toxicology Section, Centre of Forensic Sciences, 25 Morton Shulman Ave, Toronto, ON M3M 0B1, Canada.,Forensic Science Program, University of Toronto (Mississauga), Mississauga, ON L5L 1C6, Canada
| | - Teri L Martin
- Laboratory Services Section, Centre of Forensic Sciences, 25 Morton Shulman Ave, Toronto, ON M3M 0B1, Canada
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6
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McCranor BJ, Jennings L, Tressler J, Tuet WY, DeLey Cox VE, Racine M, Stone S, Pierce S, Pueblo E, Dukes A, Litvin SR, Leyden MR, Vignola JN, Pennington MR, Wong B. Assessment of naloxone as a therapeutic for inhaled carfentanil in the ferret. Toxicol Rep 2020; 7:1112-1120. [PMID: 32864344 PMCID: PMC7443168 DOI: 10.1016/j.toxrep.2020.08.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 08/10/2020] [Accepted: 08/17/2020] [Indexed: 11/28/2022] Open
Abstract
Carfentanil is a powerful synthetic opioid that is approximately 100 times more potent than fentanyl and 10,000 times more potent than morphine. Carfentanil was originally intended to be used as a sedative for big game animals in a veterinary setting, but it is becoming increasingly recognized as a public health concern. We set out to investigate the effectiveness of naloxone against a potentially lethal dose of inhaled carfentanil in male ferrets. Ferrets were implanted with telemetry devices to study cardiac parameters and exposed to aerosolized carfentanil in a whole-body plethysmography chamber to record respiratory parameters. We observed profound respiratory depression in exposed animals, which led to apneic periods constituting 24-31 % of the exposure period. Concomitant with these apneic periods, we also observed cardiac abnormalities in the form of premature junctional contractions (PJCs). At our acute exposure dose, lethal in 3 % of our animals, naïve ferrets were unresponsive and incapacitated for a total of 126.1 ± 24.6 min. When administered intramuscularly at human equivalent doses (HEDs) of either 5 mg or 10 mg, naloxone significantly reduced the time that ferrets were incapacitated following exposure, although we observed no significant difference in the reduction of time that the animals were incapacitated between the treatment groups. Naloxone was able to quickly resolve the respiratory depression, significantly reducing the frequency of apneic periods in carfentanil-exposed ferrets. Our results suggest that naloxone, when administered via intramuscular injection following incapacitation, is a viable treatment against the effects of a potentially lethal dose of inhaled carfentanil.
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Affiliation(s)
- Bryan J McCranor
- Medical Toxicology Research Division, US Army Medical Research Institute of Chemical Defense (USAMRICD), 8350 Ricketts Point Road, Aberdeen Proving Ground, MD, 21010, United States
| | - Laura Jennings
- Medical Toxicology Research Division, US Army Medical Research Institute of Chemical Defense (USAMRICD), 8350 Ricketts Point Road, Aberdeen Proving Ground, MD, 21010, United States
| | - Justin Tressler
- Medical Toxicology Research Division, US Army Medical Research Institute of Chemical Defense (USAMRICD), 8350 Ricketts Point Road, Aberdeen Proving Ground, MD, 21010, United States
| | - Wing Y Tuet
- Medical Toxicology Research Division, US Army Medical Research Institute of Chemical Defense (USAMRICD), 8350 Ricketts Point Road, Aberdeen Proving Ground, MD, 21010, United States
| | - Vanessa E DeLey Cox
- Medical Toxicology Research Division, US Army Medical Research Institute of Chemical Defense (USAMRICD), 8350 Ricketts Point Road, Aberdeen Proving Ground, MD, 21010, United States
| | - Michelle Racine
- Medical Toxicology Research Division, US Army Medical Research Institute of Chemical Defense (USAMRICD), 8350 Ricketts Point Road, Aberdeen Proving Ground, MD, 21010, United States
| | - Samuel Stone
- Medical Toxicology Research Division, US Army Medical Research Institute of Chemical Defense (USAMRICD), 8350 Ricketts Point Road, Aberdeen Proving Ground, MD, 21010, United States
| | - Samuel Pierce
- Medical Toxicology Research Division, US Army Medical Research Institute of Chemical Defense (USAMRICD), 8350 Ricketts Point Road, Aberdeen Proving Ground, MD, 21010, United States
| | - Erin Pueblo
- Medical Toxicology Research Division, US Army Medical Research Institute of Chemical Defense (USAMRICD), 8350 Ricketts Point Road, Aberdeen Proving Ground, MD, 21010, United States
| | - Aliyah Dukes
- Medical Toxicology Research Division, US Army Medical Research Institute of Chemical Defense (USAMRICD), 8350 Ricketts Point Road, Aberdeen Proving Ground, MD, 21010, United States
| | - Samantha R Litvin
- Medical Toxicology Research Division, US Army Medical Research Institute of Chemical Defense (USAMRICD), 8350 Ricketts Point Road, Aberdeen Proving Ground, MD, 21010, United States
| | - Melissa R Leyden
- Medical Toxicology Research Division, US Army Medical Research Institute of Chemical Defense (USAMRICD), 8350 Ricketts Point Road, Aberdeen Proving Ground, MD, 21010, United States
| | - Justin N Vignola
- Medical Toxicology Research Division, US Army Medical Research Institute of Chemical Defense (USAMRICD), 8350 Ricketts Point Road, Aberdeen Proving Ground, MD, 21010, United States
| | - M Ross Pennington
- Medical Toxicology Research Division, US Army Medical Research Institute of Chemical Defense (USAMRICD), 8350 Ricketts Point Road, Aberdeen Proving Ground, MD, 21010, United States
| | - Benjamin Wong
- Medical Toxicology Research Division, US Army Medical Research Institute of Chemical Defense (USAMRICD), 8350 Ricketts Point Road, Aberdeen Proving Ground, MD, 21010, United States
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7
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Clapham MO, Martin KL, Davis JL, Baynes RE, Lin Z, Vickroy TW, Riviere JE, Tell LA. Extralabel drug use in wildlife and game animals. J Am Vet Med Assoc 2020; 255:555-568. [PMID: 31429657 DOI: 10.2460/javma.255.5.555] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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8
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Thompson DP, Crouse JA, McDonough TJ, Barboza PS, Jaques S. Acute Thermal and Stress Response in Moose to Chemical Immobilization. J Wildl Manage 2020. [DOI: 10.1002/jwmg.21871] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Daniel P. Thompson
- Alaska Department of Fish and GameKenai Moose Research Center 43961 Kalifornsky Beach Road Suite B Soldotna AK 99669 USA
| | - John A. Crouse
- Alaska Department of Fish and GameKenai Moose Research Center 43961 Kalifornsky Beach Road Suite B Soldotna AK 99669 USA
| | | | - Perry S. Barboza
- Department of Wildlife and Fisheries SciencesTexas A&M University Room 274, Wildlife, Fisheries and Ecological Sciences Building, TAMU 2258 Building 1537, 534 John Kimbrough Boulevard College Station TX 77843 USA
| | - Scott Jaques
- Texas A&M Veterinary Medical Diagnostic LaboratoryTexas A&M University 483 Agronomy Road College Station TX 77840 USA
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9
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Chatterton C, Handy R, Shoemaker G, Scott-Ham M. The distribution and redistribution of carfentanil in post mortem samples. Forensic Sci Int 2020; 309:110215. [DOI: 10.1016/j.forsciint.2020.110215] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 02/14/2020] [Accepted: 02/17/2020] [Indexed: 12/26/2022]
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10
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Mass spectrometric characterization of carfentanil metabolism in human, dog, and rat lung microsomes via comparison to chemically synthesized metabolite standards. Forensic Toxicol 2020. [DOI: 10.1007/s11419-019-00521-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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11
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Hsu FL, Walz AJ, Myslinski JM, Kong L, Feasel MG, Goralski TDP, Rose T, Cooper NJ, Roughley N, Timperley CM. Synthesis and μ-Opioid Activity of the Primary Metabolites of Carfentanil. ACS Med Chem Lett 2019; 10:1568-1572. [PMID: 31749912 DOI: 10.1021/acsmedchemlett.9b00404] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 10/09/2019] [Indexed: 11/29/2022] Open
Abstract
Carfentanil is a synthetic opioid significantly more potent than clinically prescribed fentanyl. The primary metabolites of carfentanil, generated from human liver microsomes, were structurally confirmed through chemical synthesis. The synthesized compounds were evaluated for μ-opioid receptor (MOR) functional activity. Of the six metabolites assayed, a major metabolite showed comparable activity to the parent opioid. Three other metabolites showed significant MOR functional activity. The availability of the metabolites could aid improvements in the analysis of biomedical samples obtained from suspected human exposures to carfentanil and development of treatment protocols.
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Affiliation(s)
- Fu-Lian Hsu
- United States Army CCDC Chemical Biological Center, Aberdeen Proving Ground, Maryland, United States
| | - Andrew J. Walz
- United States Army CCDC Chemical Biological Center, Aberdeen Proving Ground, Maryland, United States
| | - James M. Myslinski
- United States Army CCDC Chemical Biological Center, Aberdeen Proving Ground, Maryland, United States
| | - Li Kong
- United States Army CCDC Chemical Biological Center, Aberdeen Proving Ground, Maryland, United States
| | - Michael G. Feasel
- United States Army CCDC Chemical Biological Center, Aberdeen Proving Ground, Maryland, United States
| | - Tyler D. P. Goralski
- United States Army CCDC Chemical Biological Center, Aberdeen Proving Ground, Maryland, United States
| | - Tim Rose
- Defence Science and Technology Laboratory (Dstl), Porton Down, Salisbury, Wiltshire, U.K
| | - Nicholas J. Cooper
- Defence Science and Technology Laboratory (Dstl), Porton Down, Salisbury, Wiltshire, U.K
| | - Neil Roughley
- Defence Science and Technology Laboratory (Dstl), Porton Down, Salisbury, Wiltshire, U.K
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12
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Tuet WY, Pierce SA, Racine MC, Tressler J, McCranor BJ, Sciuto AM, Wong B. Changes in murine respiratory dynamics induced by aerosolized carfentanil inhalation: Efficacy of naloxone and naltrexone. Toxicol Lett 2019; 316:127-135. [DOI: 10.1016/j.toxlet.2019.09.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 08/26/2019] [Accepted: 09/14/2019] [Indexed: 11/28/2022]
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13
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Evidence for nonlinear accumulation of the ultrapotent fentanyl analog, carfentanil, after systemic administration to male rats. Neuropharmacology 2019; 158:107596. [PMID: 30965021 DOI: 10.1016/j.neuropharm.2019.04.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 04/03/2019] [Accepted: 04/03/2019] [Indexed: 11/21/2022]
Abstract
The current opioid overdose crisis is being exacerbated by illicitly manufactured fentanyl and its analogs. Carfentanil is a fentanyl analog that is 10,000-times more potent than morphine, but limited information is available about its pharmacology. The present study had two aims: 1) to validate a method for quantifying carfentanil and its metabolite norcarfentanil in small-volume samples, and 2) to use the method for examining pharmacodynamic-pharmacokinetic relationships in rats. The analytical method involved liquid-liquid extraction of plasma samples followed by quantitation of carfentanil and norcarfentanil using ultra-high-performance liquid chromatography coupled to tandem mass spectrometry (UHPLC-MS/MS). The method was validated following SWGTOX guidelines, and both analytes displayed limits of detection and quantification at 7.5 and 15 pg/mL, respectively. Male Sprague-Dawley rats fitted with jugular catheters and temperature transponders received subcutaneous carfentanil (1, 3 and 10 μg/kg) or saline. Repeated blood specimens were obtained over 8 h, along with pharmacodynamic measures including core temperature and catalepsy scores. Carfentanil produced dose-related hypothermia and catalepsy that lasted up to 8 h. Carfentanil Cmax occurred at 15 min whereas metabolite Cmax was at 1-2 h. Concentrations of both analytes increased in a dose-related fashion, but area-under-the-curve values were much greater than predicted after 10 μg/kg. Plasma half-life for carfentanil increased at higher doses. Our findings reveal that carfentanil produces marked hypothermia and catalepsy, which is accompanied by nonlinear accumulation of the drug at high doses. We hypothesize that impaired clearance of carfentanil in humans could contribute to life-threatening effects of this ultrapotent opioid agonist. This article is part of the Special Issue entitled 'New Vistas in Opioid Pharmacology'.
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14
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Tiscione NB, Alford I. Carfentanil in Impaired Driving Cases and the Importance of Drug Seizure Data. J Anal Toxicol 2018; 42:476-484. [PMID: 29659874 DOI: 10.1093/jat/bky026] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 03/17/2018] [Indexed: 01/08/2023] Open
Affiliation(s)
- Nicholas B Tiscione
- Palm Beach County Sheriff’s Office, 3228 Gun Club Road, West Palm Beach, FL, USA
| | - Ilene Alford
- Palm Beach County Sheriff’s Office, 3228 Gun Club Road, West Palm Beach, FL, USA
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15
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Raffa RB, Pergolizzi JV, LeQuang JA, Taylor R, Colucci S, Annabi MH. The fentanyl family: A distinguished medical history tainted by abuse. J Clin Pharm Ther 2017; 43:154-158. [PMID: 28980330 DOI: 10.1111/jcpt.12640] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 09/17/2017] [Indexed: 11/30/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Beginning in the 1950s, a family of potent opioids was synthesized and developed (fentanyl and analogues). They continue to serve as valuable analgesic agents. But the recent spike and notoriety of their abuse has raised alarm, even calls for tighter control. We review the trajectory of these compounds. COMMENT To rectify shortcomings of the then available opioid analgesics, an analogue family of compounds was synthesized having a piperidine ring (presumptive principal active moiety in morphine and meperidine). The result was more potent and rapid-acting compounds, including alfentanil, carfentanil, fentanyl, sufentanil and others. These properties, plus availability in formulations for multiple routes of administration, impart broad therapeutic utility. They also unfortunately favour abuse. WHAT IS NEW AND CONCLUSION The abuse of fentanyl and its analogues (legal and illicit) serves as a case study for the dilemma and difficulties balancing a medical need against psychosocial realities. The fentanyl family provides relief for severe pain, but their very properties also engender abuse.
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Affiliation(s)
- R B Raffa
- University of Arizona College of Pharmacy, Tucson, AZ, USA.,Temple University School of Pharmacy, Philadelphia, PA, USA
| | | | | | - R Taylor
- NEMA Research, Inc., Naples, FL, USA
| | | | | | - M H Annabi
- Department of Internal Medicine, Texas Tech University Health Services Center, Lubbock, TX, USA
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16
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Eggleston W, Clemency BM. In response to: Do heroin overdose patients require observation after receiving naloxone? Clin Toxicol (Phila) 2017; 55:308. [DOI: 10.1080/15563650.2017.1284336] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- William Eggleston
- Department of Emergency Medicine, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Brian M. Clemency
- Department of Emergency Medicine, University at Buffalo, Buffalo, NY, USA
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17
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Feasel MG, Wohlfarth A, Nilles JM, Pang S, Kristovich RL, Huestis MA. Metabolism of Carfentanil, an Ultra-Potent Opioid, in Human Liver Microsomes and Human Hepatocytes by High-Resolution Mass Spectrometry. AAPS JOURNAL 2016; 18:1489-1499. [PMID: 27495118 DOI: 10.1208/s12248-016-9963-5] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 07/15/2016] [Indexed: 11/30/2022]
Abstract
Carfentanil is an ultra-potent synthetic opioid. No human carfentanil metabolism data are available. Reportedly, Russian police forces used carfentanil and remifentanil to resolve a hostage situation in Moscow in 2002. This alleged use prompted interest in the pharmacology and toxicology of carfentanil in humans. Our study was conducted to identify human carfentanil metabolites and to assess carfentanil's metabolic clearance, which could contribute to its acute toxicity in humans. We used Simulations Plus's ADMET Predictor™ and Molecular Discovery's MetaSite™ to predict possible metabolite formation. Both programs gave similar results that were generally good but did not capture all metabolites seen in vitro. We incubated carfentanil with human hepatocytes for up to 1 h and analyzed samples on a Sciex 3200 QTRAP mass spectrometer to measure parent compound depletion and extrapolated that to represent intrinsic clearance. Pooled primary human hepatocytes were then incubated with carfentanil up to 6 h and analyzed for metabolite identification on a Sciex 5600+ TripleTOF (QTOF) high-resolution mass spectrometer. MS and MS/MS analyses elucidated the structures of the most abundant metabolites. Twelve metabolites were identified in total. N-Dealkylation and monohydroxylation of the piperidine ring were the dominant metabolic pathways. Two N-oxide metabolites and one glucuronide metabolite were observed. Surprisingly, ester hydrolysis was not a major metabolic pathway for carfentanil. While the human liver microsomal system demonstrated rapid clearance by CYP enzymes, the hepatocyte incubations showed much slower clearance, possibly providing some insight into the long duration of carfentanil's effects.
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Affiliation(s)
- Michael G Feasel
- Edgewood Chemical Biological Center, Research Development and Engineering Command, U.S. Army, 5183 Blackhawk Road, Gunpowder, Maryland, 21010-5424, USA.
| | - Ariane Wohlfarth
- Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, Maryland, 21224, USA.,Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, 58758, Linköping, Sweden.,Division of Drug Research, Department of Medical Health Sciences, Linköping University, 58185, Linköping, Sweden
| | | | | | - Robert L Kristovich
- Edgewood Chemical Biological Center, Research Development and Engineering Command, U.S. Army, 5183 Blackhawk Road, Gunpowder, Maryland, 21010-5424, USA
| | - Marilyn A Huestis
- Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, Maryland, 21224, USA
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18
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Anesthesia of Tibetan Yak (Bos grunniens) Using Thiafentanil - Xylazine and Carfentanil - Xylazine. J Zoo Wildl Med 2011; 42:713-7. [DOI: 10.1638/2010-0140.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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