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Comparing methods of naloxone administration: A narrative review
Shawn E Fellows1, Alexander J Coppola2, Mona A Gandhi3
1Assistant Professor, Pharmacy Practice and Administration, Wegmans School of Pharmacy, St. John Fisher College, Rochester, New York.
Journal of Opioid Management
|September 28, 2017
Summary
Naloxone effectively reverses opioid toxicity across all tested administration routes. The optimal route for naloxone depends on the situation, patient, and provider preference, despite some data inconsistencies.
Area of Science:
- Emergency Medicine
- Pharmacology
- Toxicology
Background:
- Opioid toxicity is a significant public health concern.
- Naloxone is a critical antidote for opioid overdose.
- Various administration routes exist, each with potential benefits and drawbacks.
Purpose of the Study:
- To review the effectiveness and safety of naloxone for reversing opioid toxicity.
- To compare clinical efficacy and pharmacokinetic/pharmacodynamic properties of different naloxone administration routes.
Main Methods:
- Comprehensive literature search of PubMed, Cochrane Library, CINAHL, and Medline.
- Inclusion of clinical trials comparing intravenous, intramuscular, intranasal, subcutaneous, and nebulized naloxone.
- Exclusion of trials focusing on oral or endotracheal naloxone administration.
Main Results:
- Naloxone demonstrated clinical effectiveness regardless of administration route when compared to baseline or control.
- Inconsistencies in comparative outcome data between routes were noted.
- Variability likely stems from differences in naloxone preparation concentrations and administration methods.
Conclusions:
- Naloxone is effective in reversing opioid toxicity via all evaluated routes.
- Selection of the most appropriate naloxone administration route is multifactorial.
- Factors influencing route choice include the environment, patient specifics, and healthcare provider preference.
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