Related Experiment Videos
Naloxone: underdosage after narcotic poisoning
American Journal of Diseases of Children (1960)
|February 1, 1980
Summary
Propoxyphene poisoning in a child initially resisted standard naloxone doses. A higher dose proved effective, suggesting current recommendations may be insufficient for severe cases.
Area of Science:
- Toxicology
- Emergency Medicine
- Pediatrics
Background:
- Propoxyphene hydrochloride (Darvon) is a synthetic opioid analgesic.
- Naloxone hydrochloride is the standard reversal agent for opioid overdose.
- Standard naloxone dosages may not always be effective in severe propoxyphene poisoning.
Observation:
- A 2.5-year-old girl experienced propoxyphene hydrochloride poisoning.
- The patient remained unresponsive to initial therapeutic naloxone doses.
- Prolonged coma and artificial ventilation were required.
Findings:
- Immediate response to intravenous naloxone hydrochloride (2 mg) was observed after 3 hours of artificial ventilation.
- This effective dose was 20 times the manufacturer's recommended dosage.
- Naloxone is effective in reversing propoxyphene and pentazocine toxicity.
Implications:
- Current manufacturer-recommended naloxone dosages may be insufficient for significant propoxyphene ingestions.
- Higher or repeated naloxone doses should be considered in cases of unresponsive opioid poisoning.
- This case highlights the need to re-evaluate naloxone dosing guidelines for severe opioid toxicity in pediatric patients.