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雾化纳洛酮用于逆转美沙酮过量——一例病例报告及文献综述

Use of nebulized naloxone to reverse methadone overdose - A case report and review of literature.

作者信息

Sameed Muhammad, Teague Heidi

机构信息

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.

出版信息

J Community Hosp Intern Med Perspect. 2019 Nov 1;9(5):422-424. doi: 10.1080/20009666.2019.1659664. eCollection 2019.

Abstract

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.

摘要

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。

相似文献

4
Nebulized naloxone gently and effectively reverses methadone intoxication.
J Emerg Med. 2003 Feb;24(2):185-7. doi: 10.1016/s0736-4679(02)00723-0.
10
Intravenous use of intranasal naloxone: A case of overdose reversal.静脉注射鼻内用纳洛酮:一例过量用药逆转病例。
Subst Abus. 2017 Jan-Mar;38(1):18-21. doi: 10.1080/08897077.2016.1267686. Epub 2016 Dec 7.

本文引用的文献

7
Nebulized naloxone gently and effectively reverses methadone intoxication.
J Emerg Med. 2003 Feb;24(2):185-7. doi: 10.1016/s0736-4679(02)00723-0.
9
Subcutaneous naloxone: a less rude awakening?皮下注射纳洛酮:一种不那么粗暴的苏醒方式?
Acad Emerg Med. 1998 Apr;5(4):283-5. doi: 10.1111/j.1553-2712.1998.tb02705.x.
10
Naloxone.
Ann Emerg Med. 1983 Jul;12(7):438-45. doi: 10.1016/s0196-0644(83)80343-6.

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