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The Drug-Induced Respiratory Disease Website and App

Fentanyl

Recent data indicate that heroin may be laced with fentanyl, causing fatal ventilatory depression (PMID 25869219). Fentanyl congeners have been found in casualties following assault in a public place (PMID 23002178). Poisoning with fentanyl derivatives recently confirmed (PMID 28349714)

Frequency - Incidence

Incidence of respiratory adverse event(s) due to the specific drug as assessed by number of reported/published cases in the literature. Red digits in stars indicate: 0 = Very rare, questionable signal · 1 = < 10 cases · 2 = 10-50 cases · 3 = 50–100 cases · 4 = 100-200 cases · 5 = >200 cases

Evidence level/grade

Evidence level for respiratory adverse event(s) due to the specific drug as estimated using Hill’s (1965), Naranjo’s (1981), and Bégaud’s (1985) criteria applied to published cases. Blue digits in stars indicate: 0 = Questionable · 1 = Low · 2 = Moderate · 3 = Robust · 4 = Definite · 5 = Unquestionable, pathognomonic

I - Interstitial/parenchymal lung disease

II - Pulmonary edema - Acute lung injury - ARDS

III - Pulmonary/alveolar/airway hemorrhage/bleeding

IV - Airway involvement

VIII - Central-large-upper airway (incl. pharyngeal-nasal) involvement

IX - Neuromuscular / CNS involvement - Disordered breathing (during sleep)

X - Systemic/Distant conditions, syndromes and reactions

XI - Miscellaneous

XII - Cardiovascular involvement / toxicity