Zamani Nasim, Hassanian-Moghaddam Hossein
Toxicological Research Center, Loghman-Hakim Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, and the Excellence Center of Clinical Toxicology, Iranian Ministry of Health, Tehran, Iran.
Toxicological Research Center, Loghman-Hakim Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, and the Excellence Center of Clinical Toxicology, Iranian Ministry of Health, Tehran, Iran.
Ann Emerg Med. 2017 Jun;69(6):737-739. doi: 10.1016/j.annemergmed.2016.12.024. Epub 2017 Feb 23.
Administration of naloxone is a common treatment for opioid-dependent patients who present with respiratory depression. Although safe in opioid-naive patients, naloxone may cause severe and even life-threatening complications in opioid-dependent patients, including acute respiratory distress syndrome and myocardial infarction. It has been suggested that administration of buprenorphine, a partial μ-opioid receptor agonist, to an opioid-intoxicated patient may result in reversal of respiratory depression with less severe withdrawal signs and symptoms. In addition, the longer half-life of buprenorphine compared with naloxone may reduce the need for repetitive administration of antidote. We present a 20-year-old morphine-addicted man who presented with methadone-induced respiratory depression and responded safely and effectively to intravenous administration of buprenorphine. Buprenorphine may be a useful alternative opioid reversal agent for opioid-dependent patients.
对于出现呼吸抑制的阿片类药物依赖患者，纳洛酮是一种常用治疗药物。尽管纳洛酮对未使用过阿片类药物的患者是安全的，但在阿片类药物依赖患者中可能会引起严重甚至危及生命的并发症，包括急性呼吸窘迫综合征和心肌梗死。有人提出，对阿片类药物中毒患者使用丁丙诺啡（一种部分μ-阿片受体激动剂），可能会逆转呼吸抑制，且戒断体征和症状较轻。此外，与纳洛酮相比，丁丙诺啡的半衰期更长，可能会减少重复使用解毒剂的需求。我们报告一名20岁的吗啡成瘾男子，他出现美沙酮诱导的呼吸抑制，静脉注射丁丙诺啡后反应安全有效。对于阿片类药物依赖患者，丁丙诺啡可能是一种有用的替代阿片类逆转剂。
