A dosing nomogram for continuous infusion intravenous naloxone

Lewis Goldfrank, Richard S. Weisman, Jeffrey Keith Errick, Man Wai Lo

Research output: Contribution to journalArticle

85 Scopus citations

Abstract

Naloxone hydrochloride is extremely valuable for diagnosing and managing the opioid overdose. Due to naloxone's short half life and a long duration of action of most opioids, repeated naloxone dosing often is required to prevent the recurrence of respiratory depression. An alternative to repeated bolus administration is a continuous IV infusion. We conducted a two-phase study to determine the pharmacokinetics of naloxone and to develop a continuous dosing nomogram. In the first phase seven patients were given an IV bolus dose alone and serial plasma naloxone levels were determined. Naloxone elimination was found to be biexponential with the mean beta half life equal to 0.023 ± 0.002 reciprocal minutes in two patients and 0.015 ± 0.02 reciprocal minutes in five patients. In the second phase ten volunteers were given either a 2-mg or a 4-mg bolus dose followed by a 1.5-mg/hr or a 3-mg/hr continuous infusion. The mean volume of distribution of the central compartment was found to be 0.806 ± 0.408 L/kg. The mean beta rate constant of elimination was found to be 0.036 ± 0.027 reciprocal minutes. A computer simulation of the pharmacokinetic parameters determined in our study found that a continuous infusion of two-thirds of the bolus dose that resulted in reversal each hour will maintain the plasma naloxone levels equal to or greater than the naloxone levels that would have existed 30 minutes following the bolus dose.

Original languageEnglish (US)
Pages (from-to)566-570
Number of pages5
JournalAnnals of Emergency Medicine
Volume15
Issue number5
DOIs
StatePublished - May 1986
Externally publishedYes

Keywords

  • naloxone, IV, nomogram for

ASJC Scopus subject areas

  • Emergency Medicine

Fingerprint Dive into the research topics of 'A dosing nomogram for continuous infusion intravenous naloxone'. Together they form a unique fingerprint.

  • Cite this