title: Use of high dose naloxone in acute stroke: possible side-effects.
abstract: The effects of high dose naloxone in humans have not been studied extensively. We treated 36 patients who had acute ischemic cerebral infarction with high doses of naloxone to evaluate potential efficacy and toxicity. All patients were treated with a 160-mg/m2 (4-mg/kg) loading dose followed by 80 mg/m2.h (2 mg/kg.h) x 24 h. There were no statistically significant changes in group mean arterial pressure, respiratory rate, or heart rate in response to the loading dose or infusion, although clinically significant changes did occur in four patients. Twenty-three patients had adverse reactions possibly related to naloxone, the most common of which were nausea (n = 20), bradycardia and/or hypotension (n = 3), myoclonus (n = 1), and hypertension (n = 1). Seven patients had naloxone discontinued for possible adverse reactions. All adverse reactions abated with discontinuation of naloxone and/or pharmacologic therapy when indicated. No deaths were attributable to naloxone treatment. High dose naloxone appears to be well tolerated in the majority of elderly patients with acute cerebral infarction.
authors.affiliation: Department of Emergency Medicine, University of Cincinnati, OH.
authors.forename: W G
authors.initials: WG
authors.lastname: Barsan
authors.forename: C P
authors.initials: CP
authors.lastname: Olinger
authors.forename: H P
authors.initials: HP
authors.lastname: Adams
authors.forename: T G
authors.initials: TG
authors.lastname: Brott
authors.forename: R
authors.initials: R
authors.lastname: Eberle
authors.forename: J
authors.initials: J
authors.lastname: Biller
authors.forename: M
authors.initials: M
authors.lastname: Biros
authors.forename: J
authors.initials: J
authors.lastname: Marler
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure / Q000187:drug effects; D002544:Cerebral Infarction / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009270:Naloxone / Q000009:adverse effects* / Q000627:therapeutic use; D009325:Nausea / Q000139:chemically induced
chemical_list: D009270:Naloxone