nalorphine and Respiratory-Insufficiency

A variety of drugs have been used to antagonize the respiratory depression caused by narcotics. Some of these drugs, such as nalorphine, naloxone, butorphanol, and nalbuphine, are opiates, which interact directly with opiate receptors. Others, such as physostigmine, doxapram, and aminophylline, probably act indirectly by stimulating neuronal pathways involved in the regulation of ventilation. None of these drugs is ideal, and all have adverse side effects. Cardiovascular instability and eradication of analgesia have been troublesome, especially with the use of naloxone. The newer mixed agonist-antagonist agents, butorphanol and nalbuphine, may have significant advantages compared with naloxone. The purpose of this review is to summarize the pharmacology of the common narcotic antagonists, with an emphasis on obtaining acceptable results while avoiding adverse side effects.

Topics: Animals; Butorphanol; Humans; Nalbuphine; Nalorphine; Naloxone; Narcotic Antagonists; Respiratory Insufficiency

Controlled release morphine sulfate (MS Contin) is a relatively new oral preparation for the relief of chronic severe (cancer) pain. We describe a patient with severe neuralgia who experienced respiratory depression after ingestion of one single dose of morphine sulfate (20 mg). Administration of nalorphine chloride resulted in instant normalisation of respiratory function. This case illustrates respiratory depression as an adverse effect of MS Contin.

Topics: Aged; Delayed-Action Preparations; Female; Humans; Morphine; Nalorphine; Neuralgia; Respiratory Insufficiency

Topics: Aged; Anesthesia, Epidural; Depression, Chemical; Humans; Injections, Spinal; Male; Morphine; Nalorphine; Pain, Postoperative; Respiratory Insufficiency

The diagnosis and management of 200 cases of self-poisoning due to orally ingested crude opium in Iran is reported and discussed. Gastric lavage supported when necessary by nalorphine was effective treatment in the majority of cases because of the slow absorption of opium. Mechanical ventilation was required in twelve cases (6%) only. There were three deaths; two of these were due to pulmonary oedema which was apparently not the result of hypoxia.

Topics: Coma; Female; Gastric Lavage; Humans; Iran; Male; Nalorphine; Opium; Poisoning; Positive-Pressure Respiration; Pulmonary Edema; Respiratory Insufficiency; Suicide

Topics: Barbiturates; Dextropropoxyphene; Dialysis; Humans; Male; Middle Aged; Nalorphine; Poisoning; Respiration, Artificial; Respiratory Insufficiency

Topics: Adolescent; Child; Child, Preschool; Female; Humans; Infant; Ipecac; Male; Methadone; Nalorphine; Poisoning; Respiratory Insufficiency

Topics: Atropine; Central Nervous System; Drug Combinations; Fatigue; Female; Gastrointestinal Agents; Humans; Infant, Newborn; Isonipecotic Acids; Nalorphine; Poisoning; Reflex, Stretch; Respiratory Insufficiency; Seizures

Topics: Emergencies; Heroin; Heroin Dependence; Humans; Nalorphine; Naloxone; Pulmonary Edema; Respiratory Insufficiency; Substance-Related Disorders

Topics: Heroin; Humans; Nalorphine; Naloxone; Pulmonary Edema; Respiration; Respiratory Insufficiency; Substance-Related Disorders

Topics: Administration, Oral; Adult; Alcohol Drinking; Anemia, Hemolytic; Cellulitis; Chlorpromazine; Cyanosis; Dextropropoxyphene; Endocarditis, Bacterial; Germany, West; Humans; Injections, Intravenous; Male; Military Medicine; Nalorphine; Psychoses, Substance-Induced; Pulmonary Edema; Respiration, Artificial; Respiratory Insufficiency; Seizures; Substance-Related Disorders; Thrombophlebitis; United States

Topics: Apnea; Atropine; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Isonipecotic Acids; Male; Motion Sickness; Nalorphine; Respiratory Insufficiency

Topics: Child; Child, Preschool; Female; Gastric Lavage; Humans; Infant; Injections, Intravenous; Intubation, Intratracheal; Male; Methadone; Nalorphine; Poisoning; Respiratory Insufficiency; Substance-Related Disorders

Topics: Accidents, Home; Child; Child, Preschool; Female; Heroin; Humans; Infant; Male; Methadone; Nalorphine; Respiratory Insufficiency

Topics: Animals; Behavior, Animal; Electroencephalography; Levallorphan; Morphine; Muscle Contraction; Nalorphine; Rabbits; Respiratory Insufficiency

Topics: Atropine; Child, Preschool; Female; Gastric Lavage; Humans; Injections, Intravenous; Intubation, Intratracheal; Isonipecotic Acids; Male; Nalorphine; Respiratory Insufficiency

Topics: Adolescent; Adult; Anesthesia, Inhalation; Blood Pressure; Heart Rate; Humans; Hypoventilation; Levallorphan; Middle Aged; Nalorphine; Narcotic Antagonists; Nitrous Oxide; Oxymorphone; Pulse; Respiration; Respiratory Insufficiency; Thiopental

Topics: Dextropropoxyphene; Humans; Medication Errors; Methylphenidate; Nalorphine; Pentazocine; Respiratory Insufficiency

Topics: Acidosis, Respiratory; Asphyxia Neonatorum; Benzamides; Benzoates; Body Temperature Regulation; Catechols; Central Nervous System Stimulants; Delivery, Obstetric; Female; Fetal Diseases; Homeostasis; Humans; Infant, Newborn; Infant, Newborn, Diseases; Levallorphan; Nalorphine; Oxygen Consumption; Pregnancy; Respiration; Respiratory Insufficiency; Resuscitation; Tromethamine

Topics: Analgesics; Child; Coma; Dextropropoxyphene; Gastric Lavage; Humans; Nalorphine; Narcotic Antagonists; Poisoning; Respiratory Insufficiency; Resuscitation; Seizures; Toxicology

Topics: Aminobutyrates; Aminophylline; Bronchitis; Caffeine; Central Nervous System Stimulants; Flavones; Humans; Nalorphine; Nikethamide; Pharmacology; Pulmonary Emphysema; Pulmonary Heart Disease; Respiratory Insufficiency; Thiazoles

Topics: Acridines; Cats; Central Nervous System Stimulants; Morphine; Nalorphine; Pharmacology; Pulmonary Valve Insufficiency; Research; Respiratory Insufficiency

Topics: Anesthesia; Anesthesia, General; Anesthesiology; Humans; Morphine; Nalorphine; Respiratory Insufficiency

Topics: Animals; Barbiturates; Cell Respiration; Levallorphan; Morphine Derivatives; Nalorphine; Rats; Respiration; Respiratory Insufficiency

Topics: Analgesia; Analgesics; Levallorphan; Morphine Derivatives; Nalorphine; Pain Management; Respiration; Respiratory Insufficiency; Tartrates

Topics: Asphyxia; Barbiturates; Death; Drug Overdose; Humans; Nalorphine; Respiratory Insufficiency

Topics: Carbon Dioxide; Humans; Male; Morphine; Nalorphine; Respiration; Respiratory Insufficiency