高剂量的纳洛配方并不像我们想象的那样重要
medRxiv : the preprint server for health sciences
|August 30, 2023
概括
标准的纳洛剂量有效地逆转了大多数芬太尼的过量服用,但强效的类似物需要更多. 建议提供至少四个标准剂量,而不是用于使用毒品的人 (PWUD) 的高剂量配方.
科学领域:
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
- 成 药物 药物 药物 药物
背景情况:
- 纳洛是一种FDA批准的阿片类药物抗剂,对于逆转过量服用至关重要.
- 目前的公共分发通常包括两剂低剂量肌内 (IM) 或鼻内 (IN) 纳洛.
- 芬太尼及其类似物由于其强度而带来了独特的挑战.
研究的目的:
- 为了评估标准纳洛剂量对于芬太尼过量逆转的充分性.
- 评估高剂量纳洛配方 (HDNF) 作为溶液的有用性.
- 将吸毒者 (PWUD) 的观点纳入分析.
主要方法:
- 对纳洛的疗效和使用进行了全面的文献审查.
- 纳入了来自一个同行领导的减少伤害组织 (田纳西州减少伤害) 的见解.
- 分析了有关纳洛剂量,过量逆转和急性戒断的现有数据.
主要成果:
- 标准的IM/IN纳洛剂量有效地逆转了大多数芬太尼的过量服用,除了像卡芬坦尼尔这样的强效类型,可能需要三剂或更多剂量.
- 高剂量纳洛配方 (HDNF) 携带着急性戒断的风险,并且与标准剂量相比,在有限的证据下更昂贵.
- 重复过量可能是复苏后,这取决于阿片类药物的半衰期.
结论:
- 建议向旁观者提供至少四个标准的IN或IM纳洛剂量,并培训持续给药,直到稳定.
- 由于成本,风险和证据不足,建议不要使用HDNF作为多个标准剂量的替代品.
- 强调在所有决策过程中包括PWUD的经验,需求和同意至关重要.
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