Related Experiment Video
Updated: Dec 23, 2025
05:44
Novel Methods for Intranasal Administration Under Inhalation Anesthesia to Evaluate Nose-to-Brain Drug Delivery
Published on: November 14, 2018
20.9K
Intranasal versus Intramuscular/Intravenous Naloxone for Pre-hospital Opioid Overdose: A Systematic Review and
Mahmoud Yousefifard1, Mohammad Hossein Vazirizadeh-Mahabadi2, Arian Madani Neishaboori1
1Physiology Research Center, Iran University of Medical Sciences, Tehran Iran.
Advanced Journal of Emergency Medicine
|April 24, 2020
Summary
Intranasal naloxone is as effective as injectable naloxone for pre-hospital opioid overdose management. This systematic review suggests intranasal naloxone as a viable alternative to injections in emergency settings.
Area of Science:
- Emergency Medicine
- Pharmacology
- Toxicology
Background:
- Opioid overdose is a critical public health issue requiring immediate pre-hospital intervention.
- Naloxone is the primary antidote for opioid overdose, with various administration routes.
- Comparing intranasal and injectable naloxone efficacy in pre-hospital settings is crucial for optimizing overdose management.
Purpose of the Study:
- To systematically review and meta-analyze the efficacy of intranasal naloxone versus intramuscular/intravenous naloxone.
- To compare the effectiveness and safety of different naloxone administration routes in pre-hospital opioid overdose management.
Main Methods:
- Systematic review and meta-analysis of controlled trials.
- Extensive database search for articles published by the end of 2018.
- Statistical analysis using STATA 14.0 to compare efficacy, onset of action, and side-effects.
Main Results:
- Intranasal naloxone success rate: 82.54%; injectable naloxone success rate: 80.39%.
- No significant difference in overall efficacy between intranasal and injectable naloxone (OR=1.01, P=0.98).
- Intranasal naloxone had a slightly longer onset of action and higher odds of requiring a rescue dose, but similar major side-effect profiles.
Conclusions:
- Intranasal naloxone is as effective as injectable naloxone for pre-hospital opioid overdose management.
- Intranasal naloxone presents a safe and appropriate alternative to injectable formulations in emergency settings.
Keywords:
Drug Administration RoutesEmergency Medical ServicesNaloxoneOpioid-Related DisordersSubstance-Related DisordersMore Related Videos
Related Concept Videos
01:15Opioid Analgesics: Synthetic and Semisynthetic Opioids
814
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
814
01:25Analgesia and Pain Management
1.4K
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
1.4K
01:20Opioid Analgesics: Morphine and Other Natural Cogeners
750
Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
750
01:24Parenteral Anesthetics: Overview
506
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
506
01:18Drug Delivery: Enteral Route
1.4K
The enteral drug administration involves three primary routes: oral, sublingual, and buccal. Oral ingestion is the most prevalent, safe, economical, and convenient method for drug administration. However, it has certain drawbacks, including limited absorption due to the drug's low water solubility or poor membrane permeability, possible emesis from GI mucosa irritation, destruction of drugs by digestive enzymes or low gastric pH, and irregular absorption along with food or other drugs.
1.4K
01:22Opioid Receptors: Overview
3.7K
Opioid receptors, including the mu (μ, MOR), delta (δ, DOR), and kappa (κ, KOR) types, belong to the rhodopsin family of G protein-coupled receptors. These receptors are located throughout the central and peripheral nervous systems and in non-neuronal tissues such as macrophages and astrocytes. Opioid receptor ligands can be categorized into agonists or antagonists. Highly selective agonists include [d-Ala2, MePhe4, Gly(ol)5]-enkephalin or DAMGO for MOR, [D-Pen2,...
3.7K