Narcotic antagonists administered sublingually in heroin overdoses

Intralingual naloxone injection for narcotic-induced respiratory depression

Narcotic-induced respiratory depression in a 25-year-old man was completely reversed with the administration of intralingual naloxone. Use of this route has been advocated when the IV route is unobtainable. No specific case report or case data have been published regarding this route.

Intralingual naloxone reversal of morphine-induced respiratory depression in dogs

A descriptive study was done to determine whether naloxone is efficacious in reversing morphine-induced respiratory depression in dogs when administered intralingually into the ventral lateral surface of the tongue. Mean minute ventilation was depressed to half of resting baseline levels using fixed intravenous doses of morphine sulfate. Intralingually administered naloxone reversed this respiratory depression rapidly within one minute, and resulted in a greater than fourfold increase in mean minute ventilation above established baseline levels.

NAGD regimen for the coma of drug-related overdose

A specific arousal therapy with NAGD (Naloxone, Activated Charcoal, Glucagon, Doxapram) is outlined for victims of drug overdose in comatose and semi-comatose states. Several direct benefits accrue if early awakening or lightening of such patients is safely accomplished. There are: 1) elimination of need for prolonged intubation or tracheostomy; 2) patient's ability to tell which drug(s) were taken; 3) excessively frantic and vigorous supportive treatment is obviated; and 4) the overall hospital stay is shortened. The NAGD regimen has been found to effectively, safely, and predictably reverse coma. Therapy consists of: naloxone 0.8 mg to 1.6 mg intravenously; large-bore orogastric tube instillation of 100 gm to 120 gm activated charcoal slurry; glucagon 1 mg to 2 mg intravenously; and, in selected cases, doxapram 1 mg/kg to 2 mg/kg intravenously.

Endotracheal naloxone reversal of morphine-induced respiratory depression in rabbits

In an emergency, intravenous access may be difficult to obtain rapidly. Alternate routes of administration for drugs are, therefore, desirable. Our study was performed to determine if naloxone could be efficacious in reversing morphine-induced respiratory depression in rabbits when administered using the endotracheal route. Our results indicate that naloxone administered in this fashion is effective in reversing morphine-induced respiratory depression in the rabbit. Mean minute ventilation was depressed to greater than half of resting baseline levels using morphine sulfate. Endotracheally administered naloxone reversed this respiratory depression and resulted in a greater than five-fold increase in mean minute ventilation above baseline levels. We concluded that endotracheal naloxone is efficacious in reversing morphine-induced respiratory depression in the rabbit. The endotracheal route may be an effective alternative for naloxone administration in man when rapid intravenous access is not obtainable.