Arne Skulberg

Arne Skulberg
Norwegian University of Science and Technology | NTNU · Department of Circulation and Medical Imaging

MD PhD anaesthesiologist

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17
Publications
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91
Citations

Publications

Publications (17)
Article
Full-text available
Background: In March 2020, WHO announced the COVID-19 a pandemic and a major global public health emergency. Mortality from COVID-19 is rapidly increasing globally, with acute respiratory failure as the predominant cause of death. Many patients experience severe hypoxia and life-threatening respiratory failure often requiring mechanical ventilatio...
Article
Full-text available
Aims: To measure and evaluate clinical response to nasal naloxone in opioid overdoses in the pre-hospital environment. Design: Randomised, controlled, double-dummy, blinded, non-inferiority trial, and conducted at two centres. Setting: Participants were included by ambulance staff in Oslo and Trondheim, Norway, and treated at the place where t...
Article
Full-text available
Purpose Remifentanil has been shown to increase the bioavailability of nasally administered naloxone. The aim of this study was to explore the nature of this observation. Methods We analysed samples from three pharmacokinetic studies to determine the serum concentrations of naloxone-3-glucuronide (N3G), the main metabolite of naloxone, with or wit...
Article
Full-text available
Background Survival after out-of-hospital cardiac arrest (OHCA) is poor and dependent on high-quality cardiopulmonary resuscitation. Resuscitative endovascular balloon occlusion of the aorta (REBOA) may be advantageous in non-traumatic OHCA due to the potential benefit of redistributing the cardiac output to organs proximal to the aortic occlusion....
Article
Full-text available
Introduction Intranasal (IN) naloxone is widely used to treat opioid overdoses. The advantage of nasal administration compared with injection lies in its suitability for administration by lay people as it is needless. Approved formulations of nasal naloxone with bioavailability of approximately 50% have only undergone trials in healthy volunteers,...
Article
Full-text available
Background: Amidst the ongoing opioid crisis there are debates regarding the optimal route of administration and dosages of naloxone. This applies both for lay people administration and emergency medical services, and in the development of new naloxone products. We examined the characteristics of naloxone administration, including predictors of dos...
Preprint
Full-text available
Introduction: Amidst the ongoing opioid crisis there are debates regarding the optimal route of administration and dosages of naloxone. This applies both for lay people administration and emergency medical services, and in the development of new naloxone products. We examined the characteristics of naloxone administration, including predictors of d...
Article
Full-text available
Background: Bystander administration with naloxone nasal spray can prevent deaths from opioid overdose. To achieve optimal nasal absorption of naloxone, the spray must be administered at low volume with high concentration of the drug. The study aimed to investigate the bioavailability and absorption pattern for a new naloxone nasal spray. Materia...
Article
Background and aims: Intranasal (i.n.) naloxone is an established treatment for opioid overdose. Anyone likely to witness an overdose should have access to the antidote. We aimed to determine whether an i.n. formulation delivering 1.4 mg naloxone hydrochloride would achieve systemic exposure comparable to that of 0.8 mg intramuscular (i.m.) naloxo...
Article
Full-text available
Purpose Pharmacodynamic studies of naloxone require opioid agonism. Steady state condition may be achieved by remifentanil TCI (target controlled infusion). Opioid agonism can be measured by pupillometry. It is not known whether there are arteriovenous concentration differences for naloxone. The aim was thus to further develop a model for studying...
Article
Full-text available
Purpose: This study aimed to develop a model for pharmacodynamic and pharmacokinetic studies of naloxone antagonism under steady-state opioid agonism and to compare a high-concentration/low-volume intranasal naloxone formulation 8 mg/ml to intramuscular 0.8 mg. Methods: Two-way crossover in 12 healthy volunteers receiving naloxone while receivin...
Article
Background: Although the United States and numerous other countries are amidst an opioid overdose crisis, access to safe injection facilities remains limited. Methods: We used prospective data from ambulance journals in Oslo, Norway to describe the patterns, severity, and outcomes of opioid overdoses, and compared these characteristics among variou...
Article
Full-text available
Purpose: Nasal naloxone is wanted for bystander administration in opioid overdose and as a needle-free alternative for emergency medical personnel. Epidemiologic studies have indicated a therapeutic effect of bystander administration of low-concentration/high-volume formulations. The objective for this study was to describe the nasal pharmacokinet...
Article
Full-text available
1 highlight important aspects of the intranasal administration of naloxone. We feel that the use of unapproved, dilute formulations of naloxone should be discouraged in both lay-people and professional practitioners. Ortega et al. favor the intravenous route of access if easily obtained , claiming that this approach will achieve maximum serum conce...

Questions

Question (1)
Question
Any opinions on whether there is any use in calculate dose normalisation on Cmax (Cmax/ dose given) between various formulations and doses given of the same drug? Such calculations with the same formulations are useful for linearity, but what can they add when comparing different formulations?
Such calculations can also be assessed for statistical significant differences.
Clinical or regulatory implications?

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