Intranasal Naloxone Is a Viable Alternative to Intravenous Naloxone for Prehospital Narcotic Overdose

Robertson, Tania Mieke; Hendey, Gregory W.; Stroh, Geoff; Shalit, Marc

doi:10.1080/10903120903144866

Cited by 92 publications

(56 citation statements)

References 6 publications

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“…239 Some patients may require much higher doses to reverse intoxication with atypical opioids, such as propoxyphene, or following massive overdose ingestions. 240,241 Naloxone can be given IV, 235,236,242,243 IM, 232,235,236 intranasally, 232,242 and into the trachea. 244 The duration of action of naloxone is approximately 45 to 70 minutes, but respiratory depression caused by ingestion of a long-acting opioid (eg, methadone) may last longer.…”

Section: Opioid Toxicitymentioning

confidence: 99%

Part 12: Cardiac Arrest in Special Situations

Hoek¹,

Morrison²,

Shüster³

et al. 2010

Circulation

660

437

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Section: Opioid Toxicitymentioning

confidence: 99%

Part 12: Cardiac Arrest in Special Situations

Hoek¹,

Morrison²,

Shüster³

et al. 2010

Circulation

660

437

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“…Naloxone has an excellent safety profile and can rapidly reverse CNS and respiratory depression in a patient with an opioid-associated resuscitative emergency. Based on the rescuer's training and clinical circumstance, naloxone can be administered intravenously, [78][79][80][81] intramuscularly, 78,79,82 intranasally, 80,[82][83][84][85][86] or subcutaneously 87 ; nebulized for inhalation 88,89 ; or instilled into the bronchial tree via endotracheal tube. 90 Appropriate dose and concentrations differ by route.…”

Section: S504 Circulationmentioning

confidence: 99%

Part 10: Special Circumstances of Resuscitation

Lavonas¹,

Drennan²,

Gabrielli³

et al. 2015

Circulation

243

123

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“…In first in-human trials, nasal naloxone was found to elicit withdrawal symptoms in opioid-dependent volunteers (Loimer et al, 1992(Loimer et al, , 1994. Since the early 2000s, nasal naloxone has been used off-label by ambulance personnel (Barton et al, 2005(Barton et al, , 2002Belz et al, 2006;Kelly et al, 2005;Kerr et al, 2009;Merlin et al, 2010;Robertson et al, 2009;Weber et al, 2012) and in the emergency department (Sabzghabaee et al, 2014). More recently, improvised nasal kits (consisting of a prefilled naloxone syringe and an atomizer which fits onto the syringe to generate a nasal spray) have been provided to opioid users, peers, and families in take-home naloxone trials (Doe-Simkins et al, 2009;Dwyer et al, 2015;Walley et al, 2013aWalley et al, , 2013b, and succesful overdose reversals using improvised nasal kits have also been reported for police first responders (Rando et al, 2015).…”

Section: Sublingualmentioning

confidence: 99%

Naloxone without the needle − systematic review of candidate routes for non-injectable naloxone for opioid overdose reversal

Strang

McDonald

Alqurshi

et al. 2016

Drug and Alcohol Dependence

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. (2016). Naloxone without the needle systematic review of candidate routes for non-injectable naloxone for opioid overdose reversal. Drug and Alcohol Dependence. DOI: 10.1016DOI: 10. /j.drugalcdep.2016 Citing this paper Please note that where the full-text provided on King's Research Portal is the Author Accepted Manuscript or Post-Print version this may differ from the final Published version. If citing, it is advised that you check and use the publisher's definitive version for pagination, volume/issue, and date of publication details. And where the final published version is provided on the Research Portal, if citing you are again advised to check the publisher's website for any subsequent corrections. General rightsCopyright and moral rights for the publications made accessible in the Research Portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognize and abide by the legal requirements associated with these rights.•Users may download and print one copy of any publication from the Research Portal for the purpose of private study or research.•You may not further distribute the material or use it for any profit-making activity or commercial gain •You may freely distribute the URL identifying the publication in the Research Portal Take down policy If you believe that this document breaches copyright please contact librarypure@kcl.ac.uk providing details, and we will remove access to the work immediately and investigate your claim. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. After 40 years of injection-based naloxone treatment, non-injectable routes are finally being developed. Nasal naloxone has recently been approved and will soon be fieldtested, buccal naloxone holds promise, and it is unclear what sublingual naloxone will contribute. Development and approval of reliable non-injectable formulations will facilitate wider naloxone provision across the community internationally.

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Intranasal Naloxone Is a Viable Alternative to Intravenous Naloxone for Prehospital Narcotic Overdose

Cited by 92 publications

References 6 publications

Part 12: Cardiac Arrest in Special Situations

Part 12: Cardiac Arrest in Special Situations

Part 10: Special Circumstances of Resuscitation

Naloxone without the needle − systematic review of candidate routes for non-injectable naloxone for opioid overdose reversal

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