In addition to acute alcoholism, what other indications are naloxone? A summary of the article!

Recently, there has been a surge in searches for naloxone in the Medication Helper app! In addition to being used for acute alcoholism, what other indications does naloxone have? What are its common usage, contraindications and precautions?

Domestically approved indications and conventional doses

Acute alcoholism

Used in acute alcoholism, limited to tincture state of acute alcoholism with unstable gait, polyphony, incoherence, euphoria, ataxia, perceptual dullness, drowsiness, drowsiness, but not accompanied by coma and changes in vital signs.

◆ Dosage: Tablets: sublingual. 0.4 to 0.8 mg (1 to 2 tablets) at a time, repeatable as needed.

Injections: severe ethanol poisoning 0.8 mg to 1.2 mg, 0.4 mg to 0.8 mg after one hour.

Postoperative opioid inhibitory effects

Used after opioid compound anesthesia, it antagonizes respiratory depression caused by these drugs and prompts the patient to wake up.

◆ Conventional dosage: Partially correct the opioid inhibitory effect after the use of opioids in surgery, usually a small dose of this product is effective.

The dosage of this product should be determined according to the patient's response. When respiratory depression is first corrected, intravenously 0.1 mg to 0.2 mg should be given every 2 to 3 minutes until the desired effect is achieved, i.e., there is unimpeded breathing and wakefulness without significant pain and discomfort.

When this product is greater than the required dose, it can significantly reverse the loss of pain and raise blood pressure. Similarly, reversing too quickly can cause nausea, vomiting, sweating, or increased circulatory burden.

The amount of this product that needs to be repeatedly administered within a 1 to 2-hour interval depends on the dose of the opioid last used, the type of administration (short-acting or long-acting) and the interval.

Opioid overdose

For opioid overdose, complete or partial reversal of opioid-induced respiratory depression.

◆ Conventional dosage: the first intravenous injection of this product 0.4 mg ~ 2 mg, if the ideal anti-pneumatic function and improvement effect is not obtained, the injection can be repeated every 2 to 3 minutes. If no response is seen after 10 mg, this diagnosis should be considered. If intravenous administration is not possible, intramuscular administration may be given.

Also used in the diagnosis of acute opioid overdose.

◇This product is an opioid receptor antagonist.

◇ Because there are obvious individual differences in this product, the application should be determined by the doctor according to the specific situation of the patient and whether it is necessary to administer multiple times.

◇ This product can be administered intravenously, injected or intramuscularly, and the intravenous injection has the fastest effect and is suitable for use in the emergency department.

◇ Because the duration of action of some opioids may exceed this product, the patient should be continuously monitored and repeatedly given this product if necessary.

◇ Intravenous infusion of this product can be diluted with normal saline or glucose solution: add 2 mg of this product to any of the above liquids of 500 mL, so that the concentration reaches 0.004 mg/mL, the mixture should be used within 24 hours, and the remaining mixture that has not been used for more than 24 hours must be discarded. Control the rate of instillation according to the patient's response.

contraindication

Contraindicated in patients with known allergy to naloxone hydrochloride or any other ingredient.

Precautions

1. This product should be used with caution in patients with known or suspected opioid physical dependence, including newborns whose mothers are opioid dependent. In such cases, a sudden or complete reversal of opioid effects may cause acute withdrawal syndrome.

2. Because some opioids last longer than naloxone, patients who use this product well should be monitored continuously and repeatedly if necessary.

3. This product is ineffective in the control of respiratory depression caused by non-opioid drugs and acute toxicity caused by levopropoxyfen. Respiratory depression caused by partial agonists or mixed agonists/antagonists (e.g., buprenorphine and pentazocine) can only be partially reversed, or naloxone dosages need to be increased. If it does not respond completely, respiratory depression is clinically treated with mechanical adjuvant treatment.

4. Abrupt postoperative reversal of opioid suppression may cause nausea, vomiting, sweating, tremors, hyperthebrobbing, increased blood pressure, seizures, ventricular tachycardia and fibrillation, pulmonary edema, and cardiac arrest, which can lead to death in severe cases. Postoperative patients using this product in excess may reverse the absence of pain sensation and cause agitation in patients.

5. Patients with a history of cardiovascular disease, or other drugs with serious adverse cardiovascular reactions (hypotension, ventricular tachycardia or ventricular fibrillation, pulmonary edema) should use this product with caution.

6. After applying naloxone antagonistic high-dose anesthetic analgesics, high excitement can be generated due to the recovery of pain sensation. Manifested by increased blood pressure, increased heart rate, arrhythmias, and even pulmonary edema and ventricular fibrillation.

7. Due to the short duration of action of this drug, once the effect of the drug is gone, the patient can fall into lethargy and respiratory depression again. Medication should be taken to maintain efficacy.

8. Patients with liver disease, renal insufficiency and failure should use this product with caution.

The content is for reference only, please use in conjunction with clinical

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What is the role of naloxone in "buprenorphine/naloxone"?