Nasal administration of naloxone for detection of opiate dependence

Loimer, Norbert; Hofmann, Peter; Chaudhry, Haroon Rashid

doi:10.1016/0022-3956(92)90014-f

Cited by 34 publications

(36 citation statements)

References 10 publications

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“…opioid-dependent prisoners) to assess the pharmacodymanics of nasal naloxone (Loimer et al, 1992). However, utmost importance is necessary in design and conduct of studies in opioid-dependent volunteers with attention to the informed consent procedure to ensure that all interested subjects are properly informed and sufficiently protected from potential harm.…”

Section: Discussionmentioning

confidence: 99%

“…Preclinical data from rodent studies showed complete absorption of nasal naloxone (bioavailability relative to IV: F% = 101%; Hussain et al, 1984). 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).…”

Section: Sublingualmentioning

confidence: 99%

See 1 more Smart Citation

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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Section: Discussionmentioning

confidence: 99%

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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“…medication delivery is an alternate delivery route for injectable medications. When used with carefully selected medications, this delivery route has the advantage of rapid onset, high plasma bioavailability, direct transport to the central nervous system (CNS) across the olfactory mucosa, elimination of first pass metabolism and, perhaps most importantly, elimination of all needles (7)(8)(9)(10)(11)(12)(13). Access to the nose is also relatively immediate, especially in the prehospital setting where access to extremities through clothing can be highly variable from one patient to the next.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of intranasal naloxone as a needleless alternative for treatment of opioid overdose in the prehospital setting

Barton

Colwell

Wolfe

et al. 2005

The Journal of Emergency Medicine

123

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“…Nalokson gitt til friske frivillige vil ha lite klinisk effekt og innebaerer liten fare for bivirkninger (5). Hos heroinpåvirkede vil nalokson imidlertid utløse en abstinensreaksjon, inklusive stoffsug.…”

Section: Innledningunclassified

Nalokson nesespray kan redusere risikoen for dødelige heroinoverdoser

Lobmaier¹,

Dalsbø²,

Clausen³

2011

Nor J Epidemiol

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SAMMENDRAGBakgrunn: Antall overdosedødsfall blant heroinmisbrukere i Norge er høyt. Behandling med motgiften nalokson er kun tilgjengelig gjennom helsepersonell. Nalokson kan også gis som nesespray av ikke helsepersonell. Økt tilgjengelighet av nalokson kan redusere både antall fatale overdoser og fare for stikkskader og blodsmitte med hepatitt C og hiv blant helsepersonell. I denne artikkelen presenterer vi kunnskap om bruk av nalokson nesespray i behandling av opioidoverdoser. Material og metode: Vi har gjennomført søk etter relevant forskning om effekt av nalokson nesespray i databasene Medline, Embase og Cochrane library. Artikler er valgt ut basert på skjønn og forhåndsbestemte kriterier om behandling og pasientpopulasjon. Det var ingen restriksjoner på hvilken studiedesign som var benyttet eller metodologisk kvalitet. Konklusjonen er basert på innhentet material. Resultater: Ni relevante studier ble identifisert og inkludert, hvorav fire hadde kontrollgrupper men kun to var randomiserte sammenligninger. Ingen av studiene var utført i Norge. Nalokson nesespray gitt grunnet mistanke om opioidoverdose synes å føre til rask klinisk respons. Ved sammenligning med dagens praksis med injisert nalokson peker funn mot nesten like rask normalisering av åndedrett ved nesespray. Bruk av nalokson nesespray kan gi redusert behov for nalokson injeksjoner og derfor redusert fare for stikkskade blant helsepersonell. Hvis også legfolk utenom helsepersonell laeres opp til å gi nalokson nesespray vil tilgjengeligheten av motgift og kunnskap rundt forebygging av overdoser kunne økes. Fortolkning: Det er foreløpig for få studier av høy kvalitet til å kunne konkludere endelig med effekt av nesespray. Men de studiene som foreligger tyder på at nalokson i form av nesespray kan vaere effektiv i behandlingen av overdoser. Nalokson nesespray anbefales derfor utprøved ytterligere i randomiserte studier i Norge sammenlignet med dagens praksis. Videre bør opplaeringen i bruk for pårørende, brukere og ansatte i eksisterende lavterskeltiltak evalueres da dette vil kunne øke nalokson tilgjengeligheten og bidra til å redusere antallet overdosedødsfall.Lobmaier PPK, Dalsbø TK, Clausen T. Nasal naloxone may reduce the risk of death from heroin overdose.Nor J Epidemiol 2011; 21 (1): 107-111. ENGLISH SUMMARY Background:The number of overdose deaths among heroin users in Norway is high. Treatment with the opioid antidote naloxone is available only through trained health care staff. Naloxone can also be administered as nasal spray by non-health care staff. Increasing naloxone availability may reduce both the number of overdose deaths, the risk of needlestick injuries and the transmission of blood-borne viruses such as Hepatitis C and HIV. This paper reviews the use of nasal naloxone for the treatment of opioid overdose. Material and method:We have conducted a scoping search for relevant literature on the effects of naloxone nasal spray in the electronic databases Medline, Embase and The Cochrane Library. The reports that were judged relevant base...

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Nasal administration of naloxone for detection of opiate dependence

Cited by 34 publications

References 10 publications

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

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

Efficacy of intranasal naloxone as a needleless alternative for treatment of opioid overdose in the prehospital setting

Nalokson nesespray kan redusere risikoen for dødelige heroinoverdoser

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