A study of the effectiveness of naltrexone in preventing recurrence of methadone poisoning in opioid-naive children.
Adolescent
Aftercare
Analgesics, Opioid
/ poisoning
Child
Child, Preschool
Female
Hospitalization
Humans
Infant
Intensive Care Units
Iran
/ epidemiology
Male
Methadone
/ poisoning
Naloxone
Naltrexone
/ therapeutic use
Narcotic Antagonists
/ therapeutic use
Narcotics
Neoplasms
Patient Discharge
Poisoning
/ drug therapy
Recurrence
Retrospective Studies
Adolescent
Antagonist
Children
Naloxone
Opioids
Pediatric
Toxicity
Journal
Drug and alcohol dependence
ISSN: 1879-0046
Titre abrégé: Drug Alcohol Depend
Pays: Ireland
ID NLM: 7513587
Informations de publication
Date de publication:
01 02 2021
01 02 2021
Historique:
received:
11
08
2020
revised:
26
10
2020
accepted:
29
10
2020
pubmed:
9
12
2020
medline:
7
5
2021
entrez:
8
12
2020
Statut:
ppublish
Résumé
The prevalence of poisoning from methadone and prescription opioids is increasing in pediatric populations. Naloxone is the main antidote for treatment. Long-acting opioid toxicity may need close observation in the intensive care unit (ICU). In our previous study, naltrexone prevented re-narcotization in methadone-poisoned adults. Here, we aim to share our experience with the use of oral naltrexone for preventing recurrence of toxicity in opioid-naïve children. In a single-center, retrospective case series, children (age ≤12 years) admitted to a poison center in Tehran (Iran) between March 2014-March 2016 were included if they presented with methadone poisoning and received naltrexone treatment in hospital. Naltrexone (1 mg/kg) was administrated orally after initial administration of 0.1 mg/kg naloxone intravenously. Children were monitored for level of consciousness, cyanosis, respiratory rate, VBG results, and O2 saturation for ≥48 h during their hospitalization. Eighty patients with methadone poisoning were enrolled, with median age of three years (range: 0.2-12.0). None involved polysubstance poisoning. Following naltrexone treatment, none experienced recurrent opioid toxicity during hospitalization, and hospital records indicated no readmission within 72-h post-discharge. Oral naltrexone could be a potential substitute for continuous naloxone infusion in methadone-poisoned children and reduce the need for ICU care.
Sections du résumé
BACKGROUND
The prevalence of poisoning from methadone and prescription opioids is increasing in pediatric populations. Naloxone is the main antidote for treatment. Long-acting opioid toxicity may need close observation in the intensive care unit (ICU). In our previous study, naltrexone prevented re-narcotization in methadone-poisoned adults. Here, we aim to share our experience with the use of oral naltrexone for preventing recurrence of toxicity in opioid-naïve children.
METHODS
In a single-center, retrospective case series, children (age ≤12 years) admitted to a poison center in Tehran (Iran) between March 2014-March 2016 were included if they presented with methadone poisoning and received naltrexone treatment in hospital. Naltrexone (1 mg/kg) was administrated orally after initial administration of 0.1 mg/kg naloxone intravenously. Children were monitored for level of consciousness, cyanosis, respiratory rate, VBG results, and O2 saturation for ≥48 h during their hospitalization.
RESULTS
Eighty patients with methadone poisoning were enrolled, with median age of three years (range: 0.2-12.0). None involved polysubstance poisoning. Following naltrexone treatment, none experienced recurrent opioid toxicity during hospitalization, and hospital records indicated no readmission within 72-h post-discharge.
CONCLUSION
Oral naltrexone could be a potential substitute for continuous naloxone infusion in methadone-poisoned children and reduce the need for ICU care.
Identifiants
pubmed: 33291028
pii: S0376-8716(20)30590-1
doi: 10.1016/j.drugalcdep.2020.108425
pii:
doi:
Substances chimiques
Analgesics, Opioid
0
Narcotic Antagonists
0
Narcotics
0
Naloxone
36B82AMQ7N
Naltrexone
5S6W795CQM
Methadone
UC6VBE7V1Z
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
108425Informations de copyright
Copyright © 2020 Elsevier B.V. All rights reserved.