Empiric use of naloxone in patients with altered mental status: A reappraisal

The Evolution of Recommended Naloxone Dosing for Opioid Overdose by Medical Specialty

“…A majority of the resources surveyed recommended initial naloxone doses an order of magnitude lower than that suggested in the early 1990s [6]. The highest proportion of low-dose regimens was published in medical toxicology, emergency medicine, and general medical resources.…”

“…Naloxone became part of standard therapy for opioidinduced respiratory depression shortly after its introduction in 1967 [6]. The initial recommended dose of 0.8 to 2 mg IV naloxone was determined both by studies in animal models and through use by anesthesiologists to reverse postoperative opioid-induced respiratory depression [6].…”

“…The initial recommended dose of 0.8 to 2 mg IV naloxone was determined both by studies in animal models and through use by anesthesiologists to reverse postoperative opioid-induced respiratory depression [6]. It has since been widely used in prehospital and hospital-based settings, generally with success in its primary outcome of improving the respiratory effort of patients with opioid overdose.…”

A Five-Year Review of the Medical Outcome of Heroin Body Stuffers

“…Mild respiratory depression was considered to be present if the rate dropped below 12 breaths/min, moderate if the rate dropped below 8 breaths/min, and severe if the rate was Ͻ 4 breaths/min or apnea occurred (12). Drowsiness was considered mild central nervous system depression (13).…”

The general approach to the poisoned patient

“…If opioid toxicity is a consideration, a dose of 0.4-2 mg may be given intravenously or intranasally. 52,53 There are some important issues to consider with naloxone. Opioid tolerant patients may rapidly enter opioid withdrawal.…”