Management of Opioid Analgesic Overdose
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 . . .
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