{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T03:05:30Z","timestamp":1792638330009,"version":"4.5.0"},"reference-count":11,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>Xylazine is a type of sedative commonly used in veterinary medicine. It acts on the central alpha-2 receptor and suppresses norepinephrine release from the peripheral nerve terminal. It is also reported to have action on cholinergic, serotogenic, H2-histamine, dopaminergic, and opioid receptors. Once administered in animals, it causes hypotension, bradycardia, central nervous system depression, and respiratory depression. The effect will start within minutes after absorption and last up to 4 h depending on the dosage given. Till date, it is only exclusively used in animals as approved by the Food and Drug Administration. Human intoxication is uncommon, and no specific antidote is available. Naloxone, a competitive opioid receptor antagonist, was postulated to have an antidotal effect on xylazine. We report two cases of accidental human injection with xylazine. Naloxone was administered in one of the cases. Acute hypertension and mydriasis were observed; however, no apparent reversal of toxidrome was seen. This finding reveals the question regarding the efficacy and benefit of naloxone usage in xylazine intoxication. General management remains supportive of care focusing on ventilation and hemodynamics. Attending physicians should be aware of potential xylazine intoxication incidents in the area of livestock or veterinary activities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/tjem.tjem_198_22","type":"journal-article","created":{"date-parts":[[2023,3,26]],"date-time":"2023-03-26T03:19:20Z","timestamp":1679800760000},"page":"119-122","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":20,"title":["A case series of accidental xylazine intoxication in humans; Is there a role of naloxone as an antidote?"],"prefix":"10.4103","volume":"23","author":[{"given":"Lee Kee","family":"Choon","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ain Izzati","family":"Khiruddin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wan Masliza Wan Mohd","family":"Annuar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sazwan Reezal","family":"Shamsuddin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-8-20240909","first-page":"188","article-title":"Xylazine-induced depression and its antagonism by alpha adrenergic blocking agents","volume":"218","author":"Hsu","year":"1981","journal-title":"J Pharmacol Exp Ther"},{"key":"R2-8-20240909","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1111\/j.1365-2885.1988.tb00189.x","article-title":"Xylazine \u2013 A review of its pharmacology and use in veterinary medicine","volume":"11","author":"Greene","year":"1988","journal-title":"J Vet Pharmacol Ther"},{"key":"R3-8-20240909","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1016\/0735-6757(86)90070-7","article-title":"Human overdose with the veterinary tranquilizer xylazine","volume":"4","author":"Spoerke","year":"1986","journal-title":"Am J Emerg Med"},{"key":"R4-8-20240909","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.forsciint.2014.03.015","article-title":"Xylazine intoxication in humans and its importance as an emerging adulterant in abused drugs: A comprehensive review of the literature","volume":"240","author":"Ruiz-Col\u00f3n","year":"2014","journal-title":"Forensic Sci Int"},{"key":"R5-8-20240909","first-page":"1","article-title":"Simultaneous detection of residual diazepam, ketamine, nimetazepam, and xylazine by high-performance liquid chromatography: Application in drug-spiked beverages for forensic investigation","volume":"54","author":"Teoh","year":"2022","journal-title":"Aust J Forensic Sci"},{"key":"R6-8-20240909","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1016\/j.jemermed.2006.02.042","article-title":"Systemic toxicity after an ocular exposure to xylazine hydrochloride","volume":"30","author":"Velez","year":"2006","journal-title":"J Emerg Med"},{"key":"R7-8-20240909","first-page":"33","article-title":"Xylazine immbolization of moose with yohimbine or tolazoline as an antagonist; a comparison to carfentanil and naltrexone","volume":"33","author":"Schwartz","year":"1997","journal-title":"Alces"},{"key":"R8-8-20240909","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1016\/j.ajem.2017.06.054","article-title":"Atipamezole as an emergency treatment for overdose from highly concentrated alpha-2 agonists used in zoo and wildlife anesthesia","volume":"36","author":"Greenberg","year":"2018","journal-title":"Am J Emerg Med"},{"key":"R9-8-20240909","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1111\/j.1365-2125.1990.tb03748.x","article-title":"Pharmacological effects and pharmacokinetics of atipamezole, a novel alpha 2-adrenoceptor antagonist-a randomized, double-blind cross-over study in healthy male volunteers","volume":"30","author":"Karhuvaara","year":"1990","journal-title":"Br J Clin Pharmacol"},{"key":"R10-8-20240909","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.brainres.2013.02.030","article-title":"Xylazine induced central antinociception mediated by endogenous opioids and \u03bc-opioid receptor, but not \u03b4-or \u03ba-opioid receptors","volume":"1506","author":"Romero","year":"2013","journal-title":"Brain Res"},{"key":"R11-8-20240909","doi-asserted-by":"crossref","first-page":"e14","DOI":"10.1097\/MJT.0b013e318293b0e8","article-title":"Use of naloxone for clonidine intoxication in the pediatric age group: Case report and review of the literature","volume":"22","author":"Ahmad","year":"2015","journal-title":"Am J Ther"}],"container-title":["Turkish Journal of Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/tjem.tjem_198_22","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:11:33Z","timestamp":1787166693000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/tjem.tjem_198_22"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4]]},"references-count":11,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.4103\/tjem.tjem_198_22","relation":{},"ISSN":["2452-2473"],"issn-type":[{"value":"2452-2473","type":"print"}],"subject":[],"published":{"date-parts":[[2023,4]]}}}