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Naloxone-induced pulmonary edema.

J A Schwartz¹, M D Koenigsberg

¹Department of Emergency Medicine, University of Illinois, Chicago.

Annals of Emergency Medicine

|November 1, 1987

Summary

Naloxone, used to reverse narcotic overdose, can cause acute pulmonary edema. This case highlights the importance of using the smallest effective naloxone dose to avoid adverse events like respiratory distress.

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Area of Science:

Emergency Medicine
Clinical Toxicology
Pharmacology

Background:

Naloxone is a critical opioid antagonist used to reverse overdose.
Opioid overdose management typically involves naloxone administration.
Patient safety and adverse event monitoring are paramount in emergency medicine.

Observation:

A 68-year-old woman developed acute pulmonary edema after receiving 1.6 mg IV naloxone.
The naloxone was administered to treat a suspected codeine cough suppressant overdose.
Symptoms included agitation, tachycardia, and diaphoresis, indicative of pulmonary edema.

Findings:

Acute pulmonary edema is a potential, albeit rare, adverse effect of naloxone.
Prompt treatment with diuretics, vasodilators, and analgesics led to complete recovery.
This case underscores the need for cautious naloxone dosing.

Implications:

Clinicians should be aware of the potential for naloxone-induced pulmonary edema.
Judicious use of naloxone, employing the lowest effective dose, is recommended.
Further research into naloxone's cardiovascular and pulmonary effects is warranted.

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