Fellows Shawn E, Coppola Alexander J, Gandhi Mona A
Assistant Professor, Pharmacy Practice and Administration, Wegmans School of Pharmacy, St. John Fisher College, Rochester, New York.
Wegmans School of Pharmacy, St. John Fisher College, Rochester, New York.
J Opioid Manag. 2017 Jul/Aug;13(4):253-260. doi: 10.5055/jom.2017.0393.
The effectiveness and safety of naloxone for the reversal of opioid toxicity are reviewed. A literature search was performed using PubMed, the Cochrane Library, CINAHL, and Medline. Clinical trials comparing either the clinical efficacy or pharmacokinetic/pharmacodynamic properties displayed by intravenous, intramuscular, intranasal, subcutaneous, and nebulized naloxone were included; however, trials with primary endpoints evaluating oral or endotracheal naloxone were excluded. Naloxone was shown to be clinically effective via all routes of administration, when compared to either baseline or control. The inconsistencies in data regarding the relative outcome comparisons between administration methods were likely due to differences in concentrations of naloxone preparations and method of administration for the same route of delivery between different studies. Choice of route depends on the environment in which the opioid toxicity occurs, individual patient characteristics, and provider preference.
本文综述了纳洛酮逆转阿片类药物毒性的有效性和安全性。通过PubMed、Cochrane图书馆、CINAHL和Medline进行文献检索。纳入了比较静脉注射、肌肉注射、鼻内、皮下和雾化吸入纳洛酮所显示的临床疗效或药代动力学/药效学特性的临床试验；然而，主要终点评估口服或气管内给予纳洛酮的试验被排除。与基线或对照相比，纳洛酮经所有给药途径均显示出临床有效性。不同给药方法之间相对结果比较的数据不一致，可能是由于不同研究中纳洛酮制剂浓度以及同一给药途径给药方法的差异。给药途径的选择取决于阿片类药物毒性发生的环境、个体患者特征以及医疗服务提供者的偏好。
