Xylazine toxicity

ABSTRACT

Xylazine is a structural analog of clonidine and is an alpha-2 adrenergic receptor agonist. It is used in veterinary medicine for sedation, anesthesia, muscle relaxation, and analgesia, and it is often used with ketamine for anesthesia. Illicit drug use and overdose can result in severe mental and/or physical toxicity, including hallucinations, incoherent thought processes, hypotension, and skin necrosis. Detection is often difficult because xylazine is not identified in most drug screens used in emergency departments. There is no specific treatment except for supportive care. Clinicians should consider xylazine toxicity in patients admitted to intensive care units with non-specific clinical presentations, especially if they have unexplained skin ulcers and necrosis.

Keywords: xylazine, toxidrome, skin necrosis, tranq.