Avetian George K, Fiuty Phillip, Mazzella Silvana, Koppa Dave, Heye Vivian, Hebbar Pratibha
a Delaware County , Media , PA , USA.
b Santa Fe Mountain Center Harm Reduction Program , Santa Fe , NM , USA.
Curr Med Res Opin. 2018 Apr;34(4):573-576. doi: 10.1080/03007995.2017.1334637. Epub 2017 Jun 7.
Naloxone hydrochloride, an opioid antagonist, has been approved as a concentrated 4 mg dose intranasal formulation for the emergency treatment of known or suspected opioid overdose. This new formulation is easier to use and contains a higher dose of naloxone compared with earlier, unapproved kits. A survey of first responders and community-based organizations was conducted to understand initial real-world experiences with this new formulation for opioid overdose reversal.
In August 2016, 152 US organizations known to have received units of the approved 4 mg dose/unit naloxone nasal spray (Narcan nasal spray 4 mg; NNS) were surveyed regarding experiences using this formulation and availability of recorded data on these cases. Descriptive statistics were calculated based on the number of responses received for each item.
Eight first-responder or community-based organizations provided case report data on 261 attempted overdose reversals using NNS, with survival reported for 245 cases. Successful overdose reversals were reported in 98.8% (242/245) of cases; most cases (73.5%; 125/170) reported a time to response of ≤5 minutes after NNS administration. Heroin was the substance reportedly involved in a majority (95.4%; 165/173) of these cases; fentanyl was reported to be involved in 5.2% (9/173) of the cases. Many reversals (97.6%; 248/254) involved administration of ≤2 units of NNS. Three deaths were reported (NNS was reported to have been administered too late for two cases [the individuals were deceased prior to NNS administration]; details were not provided for the third case). The most commonly reported observed events were "withdrawal" (14.3%; 28/196); "nausea", "vomiting", or "gagging/retching" (10.2%; 20/196); and "irritability" or "anger" (8.7%; 17/196).
This survey of data provided by first-responder and community-based organizations indicated that NNS was successful at reversing the effects of opioid overdose in most reported cases.
盐酸纳洛酮作为一种阿片类拮抗剂，已被批准作为一种4毫克剂量的浓缩鼻内制剂，用于已知或疑似阿片类药物过量的紧急治疗。与早期未经批准的试剂盒相比，这种新制剂使用起来更方便，且纳洛酮剂量更高。对急救人员和社区组织进行了一项调查，以了解这种用于逆转阿片类药物过量的新制剂的初步实际使用经验。
2016年8月，对已知已收到4毫克剂量/单位纳洛酮鼻喷雾剂（纳曲酮鼻喷雾剂4毫克；NNS）的152家美国组织进行了调查，了解使用该制剂的经验以及这些病例的记录数据的可获得性。根据每个项目收到的回复数量计算描述性统计数据。
8个急救人员或社区组织提供了关于使用NNS进行261次过量逆转尝试的病例报告数据，报告有245例存活。据报告，98.8%（242/245）的病例过量逆转成功；大多数病例（73.5%；125/170）报告在给予NNS后≤5分钟出现反应。据报告，这些病例中的大多数（95.4%；165/173）涉及海洛因；据报告，5.2%（9/173）的病例涉及芬太尼。许多逆转（97.6%；248/254）涉及给予≤2单位的NNS。报告了3例死亡（据报告，有2例给予NNS太晚[个体在给予NNS之前已死亡]；未提供第三例的详细信息）。最常报告的观察到的事件是“戒断”（14.3%；28/196）；“恶心”、“呕吐”或“作呕/干呕”（10.2%；20/196）；以及“易怒”或“愤怒”（8.7%；17/196）。
这项由急救人员和社区组织提供数据的调查表明，在大多数报告的病例中，NNS成功逆转了阿片类药物过量的影响。
