| Intranasal naloxone delivery is an alternative to intravenous naloxone for opioid overdoses. | |
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MedLine Citation:
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PMID: 20223386 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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INTRODUCTION: This study proposes that intranasal (IN) naloxone administration is preferable to intravenous (IV) naloxone by emergency medical services for opioid overdoses. Our study attempts to establish that IN naloxone is as effective as IV naloxone but without the risk of needle exposure. We also attempt to validate the use of the Glasgow Coma Scale (GCS) in opioid intoxication. METHODS: A retrospective chart review of prehospital advanced life support patients was performed on confirmed opioid overdose patients. Initial and final unassisted respiratory rates (RR) and GCS, recorded by paramedics, were used as indicators of naloxone effectiveness. The median changes in RR and GCS were determined. RESULTS: Three hundred forty-four patients who received naloxone by paramedics from January 1, 2005, until December 31, 2007, were evaluated. Of confirmed opioid overdoses, change in RR was 6 for the IV group and 4 for the IN group (P = .08). Change in GCS was 4 for the IV group and 3 for the IN group (P = .19). Correlations between RR and GCS for initial, final, and change were significant at the 0.01 level (rho = 0.577, 0.462, 0.568, respectively). CONCLUSION: Intranasal naloxone is statistically as effective as IV naloxone at reversing the effects of opioid overdose. The IV and IN groups had similar average increases in RR and GCS. Based on our results, IN naloxone is a viable alternative to IV naloxone while posing less risk of needle stick injury. Additionally, we demonstrated that GCS is correlated with RR in opioid intoxication. |
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Authors:
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Mark A Merlin; Matthew Saybolt; Raffi Kapitanyan; Scott M Alter; Janos Jeges; Junfeng Liu; Susan Calabrese; Kevin O Rynn; Rachael Perritt; Peter W Pryor |
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Publication Detail:
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Type: Journal Article Date: 2010-01-28 |
Journal Detail:
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Title: The American journal of emergency medicine Volume: 28 ISSN: 1532-8171 ISO Abbreviation: Am J Emerg Med Publication Date: 2010 Mar |
Date Detail:
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Created Date: 2010-03-12 Completed Date: 2010-05-06 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8309942 Medline TA: Am J Emerg Med Country: United States |
Other Details:
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Languages: eng Pagination: 296-303 Citation Subset: IM |
Copyright Information:
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2010 Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Emergency Medicine and Pediatrics, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, USA. merlinma@umdnj.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Administration, Intranasal Adult Aged Chi-Square Distribution Female Humans Injections, Intravenous Male Middle Aged Naloxone / administration & dosage* Narcotic Antagonists / administration & dosage* Opioid-Related Disorders / drug therapy* Overdose / drug therapy* Retrospective Studies Statistics, Nonparametric Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Narcotic Antagonists; 465-65-6/Naloxone |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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