Sameed Muhammad, Teague Heidi
Department of Internal Medicine, University of Maryland Midtown, Baltimore, MD, USA.
Department of Emergency Medicine, University of Maryland Medical System, Midtown Campus, Baltimore, MD, USA.
J Community Hosp Intern Med Perspect. 2019 Nov 1;9(5):422-424. doi: 10.1080/20009666.2019.1659664. eCollection 2019.
Opioid use is a frequent cause of morbidity and mortality in the USA. We report a case of methadone overdose reversed with naloxone nebulization. Peripheral IV access can be difficult to obtain in patients with a history of IV drug abuse making needless routes of naloxone administration useful. When naloxone is administered as a bolus, chronically opioid dependent patients are more prone to violent withdrawal symptoms. When successful, nebulized naloxone reverses intoxication and allows the patient to self-titrate the discontinuation of naloxone when they are alert enough to remove the mask. Nebulized naloxone can provide needleless and noninvasive administration for the reversal of opioid overdose.
在美国，阿片类药物的使用是导致发病和死亡的常见原因。我们报告了一例通过雾化纳洛酮逆转美沙酮过量的病例。有静脉注射药物滥用史的患者可能难以建立外周静脉通路，因此，纳洛酮的非注射给药途径很有用。当大剂量注射纳洛酮时，长期阿片类药物依赖患者更容易出现剧烈的戒断症状。雾化纳洛酮成功使用时，可逆转中毒状态，且当患者恢复清醒能够摘掉面罩时，可自行调整纳洛酮的停药剂量。雾化纳洛酮可为逆转阿片类药物过量提供非注射、非侵入性给药方式。
