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Buprenorphine to reverse respiratory depression from methadone overdose in opioid-dependent patients: a prospective randomized trial.
Crit Care
February 2020
Social Determinant of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Background: Naloxone is the usual drug used in opioid-induced respiratory depression but it has a short half-life, precipitates withdrawal in dependent patients, and thus for persistent reversal of long-acting opioids has to be given by titrated doses and infusions. The partial agonist buprenorphine has a much longer duration of action and causes less severe withdrawal, but still should largely reverse respiratory depression induced by full agonist opioids. We aimed to compare the efficacy/safety of buprenorphine and naloxone in reversing respiratory depression in methadone-poisoned opioid-dependent patients.
View Article and Find Full Text PDFA case report of methadone-associated hypoglycemia in an 11-month-old male.
Clin Toxicol (Phila)
January 2018
a Harvard Medical Toxicology Program , Boston Children's Hospital, Boston , MA , USA.
Background: Methadone is a synthetic μ-opioid receptor agonist that is used in the management of pain, neonatal abstinence withdrawal syndrome, and opioid dependence. Overdose can cause miosis, respiratory depression, and central nervous system depression. Rarely, hypoglycemia has been reported.
View Article and Find Full Text PDFIntravenous Buprenorphine: A Substitute for Naloxone in Methadone-Overdosed Patients?
Ann Emerg Med
June 2017
Toxicological Research Center, Loghman-Hakim Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, and the Excellence Center of Clinical Toxicology, Iranian Ministry of Health, Tehran, Iran. Electronic address:
Administration of naloxone is a common treatment for opioid-dependent patients who present with respiratory depression. Although safe in opioid-naive patients, naloxone may cause severe and even life-threatening complications in opioid-dependent patients, including acute respiratory distress syndrome and myocardial infarction. It has been suggested that administration of buprenorphine, a partial μ-opioid receptor agonist, to an opioid-intoxicated patient may result in reversal of respiratory depression with less severe withdrawal signs and symptoms.
View Article and Find Full Text PDFRespiratory effects of diazepam/methadone combination in rats: a study based on concentration/effect relationships.
Drug Alcohol Depend
August 2013
INSERM U705, CNRS UMR8206, Université Paris Descartes, Sorbonne Paris Cité, Faculté de Pharmacie, Neuropsychopharmacologie des addictions, Paris, France.
Background: Methadone may cause respiratory depression and fatalities. Concomitant use of benzodiazepines in methadone-treated patients for chronic pain or as maintenance therapy for opiate abuse is common. However, the exact contribution of benzodiazepines to methadone-induced respiratory toxicity remains debatable.
View Article and Find Full Text PDFPharmacological Characterization of the Mechanisms Involved in Delayed Calcium Deregulation in SH-SY5Y Cells Challenged with Methadone.
Int J Cell Biol
August 2012
Neuropharmacology, Department of Medical Sciences, School of Medicine, University of Castilla-La Mancha (UCLM), 02006 Albacete, Spain.
Previously, we have shown that SH-SY5Y cells exposed to high concentrations of methadone died due to a necrotic-like cell death mechanism related to delayed calcium deregulation (DCD). In this study, we show that, in terms of their Ca(2+) responses to 0.5 mM methadone, SH-SY5Y cells can be pooled into four different groups.
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