The Medical Letter on Drugs and Therapeutics
Intranasal Naloxone for Treatment of Opioid Overdose
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The recent increase in deaths from heroin overdose in the US has led to renewed interest in the opioid antagonist naloxone, particularly in making it available as an intranasal spray to paramedics and possibly to relatives and close friends of heroin users. Intravenous (IV) administration is preferred, but peripheral venous access may be difficult to obtain in IV drug abusers, and exposure to their blood may be hazardous.

PHARMACOLOGY — Naloxone is a semisynthetic derivative of thebaine that is structurally similar to oxymorphone. It acts as a competitive antagonist at opioid receptors in the brain. Unlike other opioid antagonists, it has no opioid agonist effects. In patients with opioid overdose, naloxone begins to reverse sedation, respiratory depression, and hypotension within 1-2 minutes after IV administration and 2-5 minutes after intramuscular (IM) or subcutaneous (SC) administration. It has a half-life of 30-80 ... more      

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Title: Intranasal Naloxone for Treatment of Opioid Overdose
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