Naloxone in Buprenorphine Overdose: A Life Saving Intervention
Buprenorphine acts as a partial agonist at μ-opioid and ORL-1 (nociceptin) receptors, an antagonist at κ-opioid receptors, and an agonist at σ-opioid receptors. It is available in a range of formulations, including intravenous, sublingual, buccal and transdermal delivery systems. A serious drawback...
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| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2025-05-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/20990/78607_CE[Ra1]_F(SHU)_QC(PS_OM)_PF1(AG_SS)_PFA_NC(IS)_PN(IS).pdf |
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| Summary: | Buprenorphine acts as a partial agonist at μ-opioid and ORL-1 (nociceptin) receptors, an antagonist at κ-opioid receptors, and an agonist at σ-opioid receptors. It is available in a range of formulations, including intravenous, sublingual, buccal and transdermal delivery systems. A serious drawback of buprenorphine is its potential for abuse and overdose. For the treatment of opioid dependence, the Food and Drug Administration (FDA) authorised buprenorphine and naloxone in 2002. Naloxone, when administered subcutaneously, blocks the effects of opioid agonists by competitively binding to mu, kappa and delta opioid receptors, thereby eliminating the euphoria and reinforcing properties typically associated with abuse. A 53-year-old obese female presented to the emergency department with increased drowsiness following a road traffic accident that occurred two days prior. The patient sustained multiple rib fractures along with pulmonary contusions, as well as abrasions over the chest and elbow, for which she was prescribed buprenorphine transdermal patches at the primary healthcare facility. Non Contrast Computed Tomography (NCCT) of the brain and cervical spine revealed no acute abnormalities. There was no tenderness upon palpation of the long bones and the pelvic compression test was negative. The Focused Assessment with Sonography for Trauma (e-FAST) was also negative. Upon examination, three drug-eluting patches of undetermined composition were identified affixed to the patient’s anterior thorax and were subsequently removed. Through differential diagnosis, buprenorphine overdose was concluded, supported by significant observed clinical parameters. Naloxone was administered intravenously, followed by an infusion, resulting in a marked improvement in the patient’s condition. Within 20 minutes of receiving naloxone, the patient’s Glasgow Coma Scale (GCS) score demonstrated significant improvement, highlighting the efficacy of naloxone in reversing the effects of a buprenorphine overdose. |
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| ISSN: | 2249-782X 0973-709X |