Management of Opioid Analgesic Overdose

ArticleinNew England Journal of Medicine 367(14):1372; author reply 1372-3 · October 2012with3 Reads
Impact Factor: 55.87 · DOI: 10.1056/NEJMc1209707#SA4 · Source: PubMed

    Abstract

    To the Editor: Boyer (July 12 issue)(1) reports that use of naloxone to treat opioid overdose is logical because it is a direct antagonist of mu opioid receptors. Other strategies for treating opioid-induced respiratory depression and oversedation are now plausible and should be developed as alternatives to single-drug therapy with naloxone. Ampakines, α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptor agonists, have been shown in clinical studies to effectively antagonize opioid-induced respiratory depression.(2) Dopaminergic agonists act directly in the respiratory centers to enhance respiration(3) and presumably in the mesocortical pathways to induce arousal. Administration of amantadine is a common practice for enhancing arousal in . . .