Document Detail


Intranasal naloxone delivery is an alternative to intravenous naloxone for opioid overdoses.
MedLine Citation:
PMID:  20223386     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Journal Article     Date:  2010-01-28
Journal Detail:
Title:  The American journal of emergency medicine     Volume:  28     ISSN:  1532-8171     ISO Abbreviation:  Am J Emerg Med     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-12     Completed Date:  2010-05-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8309942     Medline TA:  Am J Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  296-303     Citation Subset:  IM    
Copyright Information:
2010 Elsevier Inc. All rights reserved.
Affiliation:
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
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MeSH Terms
Descriptor/Qualifier:
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:
0/Narcotic Antagonists; 465-65-6/Naloxone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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