Naloxone in cardiac arrest with suspected opioid overdoses

Saybolt, Matthew D.; Alter, Scott M.; Santos, Frank Dos; Calello, Diane P.; Rynn, Kevin O.; Nelson, Daniel A.; Merlin, Mark A.

doi:10.1016/j.resuscitation.2009.09.016

Cited by 28 publications

(12 citation statements)

References 19 publications

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“…A practical starting dose of 0.4mg IV should reverse most opioid-induced respiratory depression [1,2,11,13,14,16,22]. Patients with cardiopulmonary arrest require the highest dose of 2mg to effectively reverse opioid toxicity, regardless of patient's drug use history [11,23]. Dose titration should occur every 2-3 minutes until normal respiration returns (12 or more breaths per minute) [1,2,11,13,14,16,22].…”

Section: Managementmentioning

confidence: 99%

Use of naloxone for the management of opioid overdose

guyen¹

2012

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Abstract--Opioid overdose is a potentially life-threatening condition that requires immediate medical attention, often landing affected individuals into the emergency department. The longstanding treatment for opioid overdose has been naloxone, a pure opioid antagonist that reverses all signs of opioid intoxication. While effective as a reversal agent, naloxone has a half-life which is shorter than all opioids. Once the effect of naloxone wears off, patients may experience recurrence of opioid intoxication and the consequences can be fatal. The objective of this article is to review the available literature that addresses routes of administration and doses of naloxone as well as the necessary duration of observation when treating patients who present with opioid overdose. The preferred route of administration remains intravenous with intramuscular and intranasal considered alternatives. Recommended dosing is dependent upon history and the opioid being reversed; however, doses range from 0.05 -2 milligrams. A literature search revealed a relatively small number of studies related to observation periods following naloxone administration and subsequent recurrence of opioid toxicity. The available literature supports incorporation of a two-hour observation period following administration of naloxone for short-acting opioids and a longer four to six hour observation period for reversal of long-acting opioids.

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Section: Managementmentioning

confidence: 99%

Use of naloxone for the management of opioid overdose

guyen¹

2012

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“…Opioid antagonism typically occurs within minutes of naloxone administration and lasts for 45-90 min [ 45,46 ] . Repeat naloxone boluses may be needed for continuous infusion to sustain the opioid antagonistic effects [ 45,46 ] . The goal of naloxone administration is not a normal level of consciousness, rather adequate ventilation.…”

Section: Intraoperative Managementmentioning

confidence: 99%

“…The goal of naloxone administration is not a normal level of consciousness, rather adequate ventilation. When spontaneous ventilations are present, an initial dose of 0.05 mg is titrated upward every few minutes until the respiratory rate is 12 [ 45 ] . Apneic patients should receive higher initial doses of naloxone (0.2-1 mg).…”

Section: Intraoperative Managementmentioning

confidence: 99%

“…Apneic patients should receive higher initial doses of naloxone (0.2-1 mg). Patients in cardiorespiratory arrest following possible opioid overdose should be given a minimum of naloxone 2 mg [ 45 ] . In general, a lack of response to 10 mg of naloxone is required to exclude opioid toxicity, although larger doses may be required to antagonize the effects of propoxyphene, diphenoxylate, methadone, levo-alpha-acetylmethadol (LAAM), pentazocine, oxycodone, and ingested leaking drug packets [ 29,[46][47][48] .…”

Section: Intraoperative Managementmentioning

confidence: 99%

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The Anesthetic Implications of Opioid Addiction

Lewis

Souki

2011

Perioperative Addiction

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“…Na prática médica, a naloxona é indicada para reverter a depressão respiratória em pacientes com manifestações clínicas da intoxicação opioide (48). Em humanos, as evidências da naloxona no tratamento da PCR são restritas a três relatos de caso(63-65) e uma pequena série de casos retrospectiva (66 …”

Section: Naloxonaunclassified

Efeitos hemodinâmicos e metabólicos da terlipressina ou naloxona na ressuscitação cardiopulmonar: estudo experimental, randomizado e controlado

Martins¹

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Naloxone in cardiac arrest with suspected opioid overdoses

Cited by 28 publications

References 19 publications

Use of naloxone for the management of opioid overdose

Use of naloxone for the management of opioid overdose

The Anesthetic Implications of Opioid Addiction

Efeitos hemodinâmicos e metabólicos da terlipressina ou naloxona na ressuscitação cardiopulmonar: estudo experimental, randomizado e controlado

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