Naloxone therapy in opioid overdose patients: Intranasal or intravenous? A randomized clinical trial
Open accessAbstract
INTRODUCTION: This study was designed to compare the effects of intranasal (IN) and intravenous (IV) administration of naloxone in patients who had overdosed on opioids. MATERIAL AND METHODS: This randomized clinical trial study was conducted in the Department of Poisoning Emergencies at Noor and Ali Asghar (PBUH) University Hospital. One hundred opioid overdose patients were assigned by random allocation software into two study groups (n = 50). Both groups received 0.4 mg naloxone: one group IN and the other IV. Outcomes included change in the level of consciousness (measured using a descriptive scale and the Glasgow Coma Scale (GCS)), time to response, vital signs (blood pressure, heart rate and respiratory rate), arterial blood O2 saturation before and after naloxone administration, side-effects (agitation) and length of hospital stay. RESULTS: Patients who had been administered IN naloxone demonstrated significantly higher levels of consciousness than those in the IV group using both descriptive and GCS scales (p < 0.001). There was a significant difference in the heart rate between IN and IV groups (p = 0.003). However, blood pressure, respiratory rate and arterial O2 saturation were not significantly different between the two groups after naloxone administration (p = 0.18, p = 0.17, p = 0.32). There was also no significant difference in the length of hospital stay between the two groups (p = 0.14). CONCLUSIONS: Intranasal naloxone is as effective as IV naloxone in reversing both respiratory depression and depressive effects on the central nervous system caused by opioid overdose.
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The same dose of intranasal NAL is as effective as i.v. NAL in reversing effects on the central nervous system caused by opioid overdose in humans.
“It has been shown that the same dose of intranasal NAL is as effective as i.v. NAL in reversing effects on the central nervous system caused by opioid overdose in humans (59).”
From Oxytocin under opioid antagonism leads to supralinear enhancement of social attention (2017) · cites this paper as [59]
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- Authors
- Sabzghabaee, A. M., Eizadi-Mood, N., Yaraghi, A., & Zandifar, S.
- Affiliations
- Isfahan University of Medical Sciences (IR)
- Corresponding author
- Yaraghi, Ahmad
- Venue
- Archives of Medical Science
- Publisher
- Termedia Sp. z.o.o.
- Published
- 2014
- Volume
- 2
- Issue
- 2
- Pages
- 309-314
- ISSN
- 1734-1922 (ISSN-L)
- PMC
- PMC4042052
- OpenAlex
- W2043671257
- Cited by
- 53
- References
- 37
- Citations by year
- 2026: 2 · 2024: 6 · 2023: 2 · 2022: 5 · 2021: 1 · 2020: 7 · 2019: 5 · 2018: 3 · 2017: 9 · 2016: 5 · 2015: 7 · 2014: 1
- FWCI
- 7.30
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc-sa
- Locations
- Archives of Medical Science (publishedVersion, cc-by-nc-sa)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- Isfahan University of Medical Sciences
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Emergency Medicine › Poisoning and overdose treatments
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- naloxone, opioid overdose, intranasal administration, intravenous administration, route of administration comparison, respiratory depression, level of consciousness, Glasgow Coma Scale, agitation, length of hospital stay
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