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Pitfalls of intranasal naloxone

机译:鼻内纳洛酮的陷阱

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We present a case of failed prehospital treatment of fentanyl induced apnea with intranasal (IN) naloxone. While IN administration of naloxone is becoming more common in both lay and pre-hospital settings, older EMS protocols utilized intravenous (IV) administration. Longer-acting, higher potency opioids, such as fentanyl, may not be as easily reversed as heroin, and studies evaluating IN administration in this population are lacking. In order to contribute to our understanding of the strengths and limitations of IN administration of naloxone, we present a case where it failed to restore ventilation. We also describe peer reviewed literature that supports the use of IV naloxone following heroin overdose and explore possible limitations of generalizing this literature to opioids other than heroin and to IN routes of administration.
机译:我们提出一例鼻内(IN)纳洛酮治疗芬太尼诱发的呼吸暂停的院前治疗失败的情况。虽然纳洛酮的IN给药在院外和院前环境中都变得越来越普遍,但较早的EMS方案采用静脉(IV)给药。长效,高效力的阿片类药物(如芬太尼)可能不像海洛因那样容易逆转,因此缺乏评估该人群IN给药的研究。为了有助于我们了解纳洛酮IN给药的优势和局限性,我们提出了无法恢复通气的情况。我们还描述了同行评议的文献,这些文献支持在海洛因过量后使用IV纳洛酮,并探讨了将该文献推广至除海洛因以外的阿片类药物和IN给药途径的可能局限性。

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