Articles: narcotic-antagonists.
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Ann Fr Anesth Reanim · Jan 1997
Case Reports[A low dose of nalbuphine reverses respiratory depression but not analgesia induced by intraspinal morphine].
Postoperative pain management after scoliosis surgery is based in our institution on intrathecal morphine administration. This case report describes an immediate and major postoperative respiratory depression that occurred in the recovery room, requiring the maintenance of the endotracheal tube. This respiratory depression was reversed by i.v. administration of a low dose of nalbuphine, which allowed tracheal extubation without suppression of morphine-induced analgesia.
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Clin. Pharmacol. Ther. · Jan 1997
Effects of liver disease on the disposition of the opioid antagonist nalmefene.
The pharmacokinetics of nalmefene and its glucuronide metabolite were investigated in 12 patients with liver disease (four patients with mild, five patients with moderate, and three patients with severe liver disease) and 12 age-, weight-, and gender-matched control subjects. ⋯ The clearance of nalmefene was significantly reduced in the presence of liver disease. However, because nalmefene will be primarily used in the acute care setting for reversal of opioid-induced effects, it is not likely that these alterations will necessitate a dosage modification.
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Arzneimittel Forsch · Jan 1997
Comparative StudyStudies on the abstinence-like overshoot following reversal of the potent 19-isoamyl derivative of etorphine with naloxone. A comparison with the opioids fentanyl and alfentanil.
Reversal of opioid-related respiratory depression is often accompanied by an "acute abstinence like syndrome" with hypertension, tachycardia, and pain. This overshoot was used to investigate the extent at which opioids of high potency but different structure are involved in naloxone-induced abstinence. In 10 awake and trained mongrel dogs two highly mu-selective compounds, alfentanil and fentanyl, were given in cumulative doses and at different occasions (30-60-120-240 micrograms/kg, and 6-12-24-48 micrograms/kg, respectively). ⋯ However, no precipitation on an acute abstinence-like syndrome affecting antinociception or inducing cardiovascular overshoot was observed. This may stem from an intense binding and slow dissociation of the ligand from the receptor site or may be due to high binding affinity to both the mu and the kappa receptor site. Opioids which interact with various receptor sites may be of clinical interest for substitution therapy in opioid dependent addicts.
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Randomized Controlled Trial Clinical Trial
Randomised crossover trial of naltrexone in uraemic pruritus.
Most dialysis patients develop pruritus, for which current treatment is unsatisfactory. Endogenous opioids may be involved in this pruritus. We studied the effect of the opioid antagonist naltrexone on the pruritus of haemodialysis patients. ⋯ Our data suggest short-term efficacy with few side-effects for the amelioration of uraemic pruritus with naltrexone.