title: Patterns of naloxone use in hospitalized patients.
abstract: OBJECTIVE
  Naloxone is indicated for reversal of opioid-induced respiratory depression. The objective of this study is to evaluate patterns of naloxone use in hospitalized patients.
  
  
  METHODS
  Retrospective chart review at the University of California, San Diego Health. Subjects included adults ≥18 years old who were admitted to and received naloxone in the medical-surgical, telemetry, intermediate care, or obstetrics/gynecology units from May 1st, 2014 to April 30th, 2015. The primary endpoint was to determine the percentage of naloxone administrations that resulted in an improvement in sedation. Secondary endpoints included the percentage of naloxone administrations that reversed respiratory depression and any association of naloxone use with opioid routes of administration, other concomitant central nervous system depressants, or disease states. Data were analyzed using descriptive and contingency statistics.
  
  
  RESULTS
  124 episodes of naloxone were identified during the study period. 62% of naloxone administrations resulted in an improved level of consciousness. In contrast to this, only 30 (24.2%) episodes of naloxone administration met the criteria for respiratory depression. Of these 30 episodes, naloxone reversed respiratory depression in 25 (83.3%) of them. The most frequent opioid routes of administration were short-acting oral (53.2%) and IV opioids (44.4%). Of the concomitant medications, gabapentin (28.2%) was the most frequently associated sedating medication.
  
  
  CONCLUSIONS
  In our study, naloxone was more often used for reversal of sedation than for respiratory depression. Gabapentin may pose a risk factor for oversedation when combined with opioids, leading to increased naloxone use. Further studies are needed to explore these patterns.
authors.affiliation: a Department of Pharmacy , UC San Diego Health , San Diego , CA , USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Yung
authors.affiliation: a Department of Pharmacy , UC San Diego Health , San Diego , CA , USA.|b UC San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences , La Jolla , CA , USA.
authors.forename: Kelly C
authors.initials: KC
authors.lastname: Lee
authors.affiliation: a Department of Pharmacy , UC San Diego Health , San Diego , CA , USA.
authors.forename: Chih
authors.initials: C
authors.lastname: Hsu
authors.affiliation: c Department of Anesthesiology , UC San Diego Health , San Diego , CA , USA.
authors.forename: Timothy
authors.initials: T
authors.lastname: Furnish
authors.affiliation: a Department of Pharmacy , UC San Diego Health , San Diego , CA , USA.|b UC San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences , La Jolla , CA , USA.
authors.forename: Rabia S
authors.initials: RS
authors.lastname: Atayee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000009:adverse effects* / Q000627:therapeutic use*; D002140:California; D016292:Procedural Sedation / Q000379:methods; D003243:Consciousness / Q000187:drug effects; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007297:Inpatients / Q000706:statistics & numerical data; D008168:Lung / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D009270:Naloxone / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D010146:Pain / Q000188:drug therapy*; D012131:Respiratory Insufficiency / Q000188:drug therapy*; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000701:Analgesics, Opioid; D006993:Hypnotics and Sedatives; D009292:Narcotic Antagonists; D009270:Naloxone
keywords: Naloxone; Opioid-related sedation; POSS; opioid analgesics; respiratory depression