title: Intravenous Buprenorphine: A Substitute for Naloxone in Methadone-Overdosed Patients?
abstract: 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. In addition, the longer half-life of buprenorphine compared with naloxone may reduce the need for repetitive administration of antidote. We present a 20-year-old morphine-addicted man who presented with methadone-induced respiratory depression and responded safely and effectively to intravenous administration of buprenorphine. Buprenorphine may be a useful alternative opioid reversal agent for opioid-dependent patients.
authors.affiliation: 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.
authors.forename: Nasim
authors.initials: N
authors.lastname: Zamani
authors.affiliation: 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: hassanian@sbmu.ac.ir.
authors.forename: Hossein
authors.initials: H
authors.lastname: Hassanian-Moghaddam
mesh_terms: D061605:Administration, Intravenous; D002047:Buprenorphine / Q000627:therapeutic use*; D062787:Drug Overdose / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008691:Methadone / Q000506:poisoning*; D009270:Naloxone / Q000009:adverse effects*; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D012131:Respiratory Insufficiency / Q000139:chemically induced*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D009292:Narcotic Antagonists; D009270:Naloxone; D002047:Buprenorphine; D008691:Methadone