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Adv Exp Med Biol. 2008;605:486-91.

Naloxone reversal of opioid-induced respiratory depression with special emphasis on the partial agonist/antagonist buprenorphine.

Author information

1
Leiden University Medical Center, Department of Anesthesiology, 2300 RC Leiden, The Netherlands. e.y.sarton@lumc.nl

Abstract

Buprenorphine is relatively resistant to reversal by naloxone. We tested the effect of various doses and infusion schemes of naloxone on buprenorphine-induced respiratory depression and compared the data with naloxone-reversal of morphine and alfentanil-induced respiratory depression. Both morphine and alfentanil were easily reversed by low doses of naloxone (0.4 mg). Increasing doses of naloxone caused a bell-shaped reversal curve of buprenorphine with maximal reversal at naloxone doses between 2 and 4 mg. However, reversal was short-lived. The bell-shaped reversal curve may be related to the existence of two mu-opioid receptor subtypes, one mediating the agonist effects of opioids at low dose, the other mediating antagonistic effects at high dose.

PMID:
18085322
DOI:
10.1007/978-0-387-73693-8_85
[Indexed for MEDLINE]

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