• Maarten van Lemmen, Jeffrey Florian, Zhihua Li, Monique van Velzen, Eveline van Dorp, Marieke Niesters, Elise Sarton, Erik Olofsen, Rutger van der Schrier, David G Strauss, and Albert Dahan.
• Department of Anesthesiology, Leiden University Medical Center, Leiden, The Netherlands.
• Anesthesiology. 2023 Sep 1; 139 (3): 342353342-353.

AbstractOpioids are effective analgesics, but they can have harmful adverse effects, such as addiction and potentially fatal respiratory depression. Naloxone is currently the only available treatment for reversing the negative effects of opioids, including respiratory depression. However, the effectiveness of naloxone, particularly after an opioid overdose, varies depending on the pharmacokinetics and the pharmacodynamics of the opioid that was overdosed. Long-acting opioids, and those with a high affinity at the µ-opioid receptor and/or slow receptor dissociation kinetics, are particularly resistant to the effects of naloxone. In this review, the authors examine the pharmacology of naloxone and its safety and limitations in reversing opioid-induced respiratory depression under different circumstances, including its ability to prevent cardiac arrest.Copyright © 2023 American Society of Anesthesiologists. All Rights Reserved.

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