Bradberry J C, Raebel M A
Drug Intell Clin Pharm. 1981 Dec;15(12):945-50. doi: 10.1177/106002808101501205.
Based on the pharmacokinetic parameters of naloxone and the clinical studies discussed in this paper, it is evident that naloxone infusion may be useful in cases of opiate overdose. The infusion protocol presented in Appendix I was formulated based on the pharmacokinetic data available from the literature including Nelson's animal data. An infusion of naloxone was used with apparent success in the two cases presented. Both patients presented with narcotic overdose; although immediate patient history could not be obtained, the presentations were classic for narcotic overdose. It is of note that it may be possible to keep a patient from relapsing into narcosis after overdose by the use of naloxone infusion. Additionally, the extreme safety of naloxone is certainly an advantage with any administration technique. We feel that the administration of continuous infusion of naloxone is an especially important advance in the overdose treatment of longer-acting agents such as methadone, as well as of other narcotics. Therefore, it is recommended that further clinical trials of naloxone by infusion be undertaken, as suggested by J. Nelson, et al. (A protocol for treatment with continuous infusion of naloxone [Narcan] in selected cases of opiate [narcotic] overdose. Austin: University of Texas; May, 1976, unpublished), to further document the effectiveness of an infusion of naloxone in narcotic overdose.
根据纳洛酮的药代动力学参数以及本文讨论的临床研究,显然纳洛酮静脉输注在阿片类药物过量的情况下可能有用。附录I中提出的输注方案是根据包括纳尔逊动物数据在内的文献中可得的药代动力学数据制定的。在给出的两个病例中,使用纳洛酮静脉输注取得了明显成功。两名患者均表现为麻醉药过量;虽然无法立即获取患者病史,但这些表现是麻醉药过量的典型症状。值得注意的是,通过使用纳洛酮静脉输注,有可能防止患者在过量用药后再次陷入麻醉状态。此外,纳洛酮的极高安全性对于任何给药技术而言无疑都是一个优势。我们认为,持续输注纳洛酮在美沙酮等长效药物以及其他麻醉药的过量治疗中是一项尤为重要的进展。因此,建议按照J.纳尔逊等人(《纳洛酮持续静脉输注治疗阿片类(麻醉药)过量特定病例的方案》。奥斯汀:德克萨斯大学;1976年5月,未发表)的建议,开展纳洛酮静脉输注的进一步临床试验,以进一步证明纳洛酮静脉输注在麻醉药过量治疗中的有效性。