II. Mechanism
- Adrenergic alpha-2 Agonist (similar to Clonidine, Dexmedetomidine) with central acting decrease in sympathetic tone
- Used as a Sedative, Analgesic and centrally acting Muscle relaxant in veterinary medicine
- Street name, "Horse Tranquilizer", added to injection Drugs of Abuse (e.g. Fentanyl, Cocaine) to enhance euphoria
- Associated with Opioid Overdose deaths, and unresponsive to Naloxone
III. Pharmacokinetics
- Typically injected, but is also well absorbed with ingested or insufflated
- Half-Life: 5 hours after injection
- Symptoms manifest with as little as 10 mg injected
IV. Findings
- Overdose unresponsive to Naloxone
- Neurologic
- Pupil Constriction (Miosis)
- Sedation
- Respiratory Depression
- Cardiovascular
- Bradycardia
- Hypotension (may follow initial Hypertension)
- Endocrine
- Hyperglycemia (mild)
- Skin
- Ulcerations at injection site
V. Labs
- See Unknown Ingestion
- Bedside Glucose
- No drug levels are available
VI. Diagnostics
VII. Management
- See Unknown Ingestion
-
Decontamination
- Consider Activated Charcoal if large ingestion within prior hour and protected airway
- Supportive Care
- Naloxone for Opioid coingestion reversal
- Endotracheal Intubation if indicated
- Supplemental Oxygen
- Symptomatic Bradycardia
- Hypotension
- Significant Ventricular Dysrhythmia
- Disposition
- Admit all symptomatic patients (e.g. Symptomatic Bradycardia, Hypotension)
- May discharge if asymptomatic at 4 to 6 hours from use
VIII. References
- Tomaszewski (2022) Crit Dec Emerg Med 36(6): 32
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Related Studies
| Definition (MSH) | An adrenergic alpha-2 agonist used as a sedative, analgesic and centrally acting muscle relaxant in VETERINARY MEDICINE. |
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | D014991 |
| English | Xylaxine, Xylazin, Xylazine, 4H-1,3-Thiazin-2-amine, N-(2,6-dimethylphenyl)-5,6-dihydro-, Xylazine [Chemical/Ingredient], xylaxine, xylazin, xylazine, XYLAZINE |
| Swedish | Xylazin |
| Czech | xylazin |
| Finnish | Ksylatsiini |
| Russian | KSILAZIN, КСИЛАЗИН |
| Japanese | キシラジン, リン酸キシラジン, ザイラジン, りん酸キシラジン, キシラジン塩酸塩, ロンプン, ロムプン, 塩酸キシラジン |
| French | Xylaxine, Xylazine |
| Polish | Ksylazyna |
| German | Xylazin |
| Italian | Xilazina |
| Portuguese | Xilazina |
| Spanish | Xilazina |
