Nebulized naloxone in opiate intoxication

3.5 out of 5 stars Use and efficacy of nebulized naloxone in patients with suspected opioid intoxication. Baumann BM et al. Am J Emerg Med 2013 Jan 21.  [Epub ahead of print] Abstract The use of intravenous naloxone to reverse opiate effects is associated with many potential adverse events, some well-known and others not sufficiently recognized. Even relatively small doses of IV naloxone can cause acute withdrawal, severe agitation, and emesis. If the patient has another CNS depressant on board — such as ethanol — he may vomit but not be alert enough to protect the airway. In addition, acute withdrawal is sometimes associated with catecholamine surge, hypertension, and pulmonary edema. If severe respiratory depression is evident, the prehospital or emergency team must be prepared to perform endotracheal intubation and assisted ventilation, or quickly administer adequate doses of antidote. However, the majority of opiate-affected patients do not present with incipient respiratory failure, and may not need naloxone at all. However, often the clinician feels that he or she “must do something”, and administers IV naloxone. This is an intervention often regretted as the patient — who had been slightly obtunded but stable and manageable — becomes extremely agitated uncooperative, and very very unappreciative. In this situation, nebulized naloxone may be the preferred route which, as a previous report claimed, can “gently and effectively” reverse o...
Source: The Poison Review - Category: Toxicology Authors: Tags: Medical naloxone narcotic overdose nebulized opiate opioid Source Type: news