Harborview Medical Center, Department of Emergency Medicine, University of Washington, 325 Ninth Avenue, Seattle, WA, 98104-2499, USA.
Washington Poison Center, Seattle, WA, USA.
J Med Toxicol. 2019 Apr;15(2):134-135. doi: 10.1007/s13181-018-0695-z. Epub 2019 Jan 10.
Take-home naloxone, an opioid antagonist, has become part of a multimodal approach to curbing opioid-related mortality. However, there is little information about the utility of take-home naloxone in pediatric patients. We report a case of opioid toxicity after exposure to methadone in a pediatric patient, which was successfully reversed with take-home naloxone.
A previously healthy 22-month-old girl ingested an unknown amount of liquid methadone. The child became progressively somnolent. The mother administered intranasal naloxone at home with reversal of somnolence. The patient presented to the emergency department and had recurrence of symptoms. The patient was placed on a naloxone infusion and discharged from a tertiary care facility, uneventfully, 2 days after ingestion.
To our knowledge, we report the first case of pediatric opioid toxicity reversed by take-home naloxone. In the setting of rising opioid-related mortality, providers and public health officials should consider expanding access of take-home naloxone for children at high risk for opioid overdose.
美沙酮是一种阿片类拮抗剂，已成为遏制阿片类药物相关死亡率的多模式方法的一部分。然而，关于美沙酮在儿科患者中的应用效果的信息很少。我们报告了一例儿童患者因接触美沙酮而出现阿片类药物中毒的病例，该病例通过家庭使用美沙酮成功逆转。
一名此前健康的 22 个月大女孩摄入了未知量的液态美沙酮。孩子逐渐变得昏昏欲睡。母亲在家中给予了鼻内美沙酮，使孩子恢复了清醒。患儿因症状复发而就诊于急诊部。患儿接受了纳洛酮输注治疗，并在摄入后 2 天，安然无恙地从三级护理机构出院。
据我们所知，我们报告了首例经家庭使用美沙酮逆转的儿科阿片类药物中毒病例。在阿片类药物相关死亡率上升的背景下，提供者和公共卫生官员应考虑扩大高危儿童获得家庭使用美沙酮的机会，以防阿片类药物过量。
