cover image: Naloxone for respiratory depression in patients with drug or addiction issues

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Naloxone for respiratory depression in patients with drug or addiction issues

4 Oct 2012

Natural or synthetic opioids can be used therapeutically, recreationally, and children may be unintentionally exposed to them. Opioid addiction and abuse is a major medical and social problem all around the world. Opioid antagonists are commonly used as rescue medications to reverse severe opioid-induced respiratory depression. Naloxone is a non-selective, short-acting opioid receptor antagonist which acts on the mu-, delta- and kappa-opioid receptors. It has been approved by Health Canada as an opioid antagonist since 1994.7 The most common use of naloxone is for the treatment of opioid overdose in both hospital and out-patient settings, and in rapid detoxification (being given intravenously [i.v.] when combined with other medications). The safety of naloxone is well established in patients and healthy volunteers over a wide dose range (0.4 to 10 mg). However, clinical studies have indicated that naloxone may be associated with serious adverse effects, such as pulmonary edema, cardiac arrhythmias, hypertension / hypotension, seizures, and violent behavior. In addition, continuous monitoring of naloxone is recommended due to its shorter duration of action. The purpose of this review is to assess the evidence of harms related to the use of naloxone in management of respiratory depression in patients with polypharmacy intoxication or opioid dependence. Evidence-based guidelines and recommendation for the dosing of naloxone in this population will also be discussed.
health research systematic reviews drugs chemicals medicine health care prescription drugs evidence-based medicine therapy clinical trial clinical medicine opioid-related disorders polypharmacy randomized controlled trials drug overdose evidence-based healthcare policy dependence health treatment health sciences clinical meta-analyses dose (biochemistry) naloxone medical drugs opioid pharmaceutical major depressive disorder randomized
Pages
8
Published in
Canada

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