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Pitfalls of Intranasal Naloxone

, MD, , MPH, MD, FACEP & , MD, PhD, FACEP

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Sarah G. Mahonski, James B. Leonard, J. David Gatz, Hyunuk Seung, Erin E. Haas & Hong K. Kim. (2020) Prepacked naloxone administration for suspected opioid overdose in the era of illicitly manufactured fentanyl: a retrospective study of regional poison center data. Clinical Toxicology 58:2, pages 117-123.
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Hong K. Kim, Nicholas J. Connors & Maryann E. Mazer-Amirshahi. (2019) The role of take-home naloxone in the epidemic of opioid overdose involving illicitly manufactured fentanyl and its analogs. Expert Opinion on Drug Safety 18:6, pages 465-475.
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Mark J. Elzey, Jeffrey Fudin & Eric S. Edwards. (2017) Take-home naloxone treatment for opioid emergencies: a comparison of routes of administration and associated delivery systems. Expert Opinion on Drug Delivery 14:9, pages 1045-1058.
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Mark Faul, Peter Lurie, Jeremiah M. Kinsman, Michael W. Dailey, Charmaine Crabaugh & Scott M. Sasser. (2017) Multiple Naloxone Administrations Among Emergency Medical Service Providers is Increasing. Prehospital Emergency Care 21:4, pages 411-419.
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Scott G. Weiner, Patricia M. Mitchell, Elizabeth S. Temin, Breanne K. Langlois & K. Sophia Dyer. (2017) Use of Intranasal Naloxone by Basic Life Support Providers. Prehospital Emergency Care 21:3, pages 322-326.
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Michael Levine, Stephen Sanko & Marc Eckstein. (2016) Assessing the Risk of Prehospital Administration of Naloxone with Subsequent Refusal of Care. Prehospital Emergency Care 20:5, pages 566-569.
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Matthew Zuckerman, Stacy N. Weisberg & Edward W. Boyer. (2015) Pitfalls of Intranasal Narcan – Response to a Letter to the Editor. Prehospital Emergency Care 19:1, pages 138-139.
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Corey S. Davis, Caleb J. Banta-Green, Phillip Coffin, Michael W. Dailey & Alexander Y. Walley. (2015) Intranasal Naloxone for Opioid Overdose Reversal. Prehospital Emergency Care 19:1, pages 135-137.
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Articles from other publishers (29)

Eric J. Lavonas, Peter D. Akpunonu, Ann M. Arens, Kavita M. Babu, Dazhe Cao, Robert S. Hoffman, Christopher O. Hoyte, Maryann E. Mazer-Amirshahi, Andrew Stolbach, Maude St-Onge, Trevonne M. Thompson, George Sam Wang, Amber V. Hoover & Ian R. Drennan. (2023) 2023 American Heart Association Focused Update on the Management of Patients With Cardiac Arrest or Life-Threatening Toxicity Due to Poisoning: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation.
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Akeemat O. Tijani, Amruta A. Dandekar, Tanvi Karve, Ajay K. Banga & Ashana Puri. (2023) Transdermal delivery of naloxone hydrochloride using minimally invasive physical ablation techniques. International Journal of Pharmaceutics 642, pages 123159.
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Ngocdung T. Tran, Ibrahim K. Muradian, Nazia Qureshi, Jimmy Singh & Sean O. Henderson. (2023) Characterizing and combating the opioid epidemic in the Los Angeles County jail system. Journal of Substance Use and Addiction Treatment 147, pages 208984.
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N. Cavanagh, I. E. Blanchard, D. Weiss & W. Tavares. (2023) Looking back to inform the future: a review of published paramedicine research. BMC Health Services Research 23:1.
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Marta Tikhomirov, Paweł Jajor, Tomasz Śniegocki & Błażej Poźniak. (2022) Predicting the efficacy of opioid sequestration by intravenous lipid emulsion using biologically relevant in vitro models of drug distribution. Scientific Reports 12:1.
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Stevie C. Britch & Sharon L. Walsh. (2022) Treatment of opioid overdose: current approaches and recent advances. Psychopharmacology 239:7, pages 2063-2081.
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Andrew J. Kassick, Mariah Wu, Diego Luengas, Mohammad Ebqa’ai, L. P. Tharika Nirmani, Nestor Tomycz, Toby L. Nelson, Marco Pravetoni, Michael D. Raleigh & Saadyah Averick. (2021) Covalently Loaded Naloxone Nanoparticles as a Long-Acting Medical Countermeasure to Opioid Poisoning. ACS Pharmacology & Translational Science 4:5, pages 1654-1664.
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Alex S. Bennett & Luther Elliott. (2021) Naloxone's role in the national opioid crisis—past struggles, current efforts, and future opportunities. Translational Research 234, pages 43-57.
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Miriam Boeri & Aukje K. Lamonica. (2021) Naloxone perspectives from people who use opioids: Findings from an ethnographic study in three states. Journal of the American Association of Nurse Practitioners 33:4, pages 294-303.
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Ashish R. Panchal, Jason A. Bartos, José G. Cabañas, Michael W. Donnino, Ian R. Drennan, Karen G. Hirsch, Peter J. Kudenchuk, Michael C. Kurz, Eric J. Lavonas, Peter T. Morley, Brian J. O’Neil, Mary Ann Peberdy, Jon C. Rittenberger, Amber J. Rodriguez, Kelly N. Sawyer, Katherine M. Berg, Julie Arafeh, Justin L. Benoit, Maureen Chase, Antonio Fernandez, Edison Ferreira de Paiva, Bryan L. Fischberg, Gustavo E. Flores, Peter Fromm, Raul Gazmuri, Blayke Courtney Gibson, Theresa Hoadley, Cindy H. Hsu, Mahmoud Issa, Adam Kessler, Mark S. Link, David J. Magid, Keith Marrill, Tonia Nicholson, Joseph P. Ornato, Garrett Pacheco, Michael Parr, Rahul Pawar, James Jaxton, Sarah M. Perman, James Pribble, Derek Robinett, Daniel Rolston, Comilla Sasson, Sree Veena Satyapriya, Travis Sharkey, Jasmeet Soar, Deb Torman, Benjamin Von Schweinitz, Anezi Uzendu, Carolyn M. Zelop & David J. Magid. (2020) Part 3: Adult Basic and Advanced Life Support: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 142:16_suppl_2.
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Alexis A. Topjian, Tia T. Raymond, Dianne Atkins, Melissa Chan, Jonathan P. Duff, Benny L. JoynerJrJr, Javier J. Lasa, Eric J. Lavonas, Arielle Levy, Melissa Mahgoub, Garth D. Meckler, Kathryn E. Roberts, Robert M. Sutton, Stephen M. Schexnayder, Ronald A. Bronicki, Allan R. de Caen, Anne Marie Guerguerian, Kelly D. Kadlec, Monica E. Kleinman, Lynda J. Knight, Taylor N. McCormick, Ryan W. Morgan, Joan S. Roberts, Barnaby R. Scholefield, Sarah Tabbutt, Ravi Thiagarajan, Janice Tijssen, Brian Walsh & Arno Zaritsky. (2020) Part 4: Pediatric Basic and Advanced Life Support: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 142:16_suppl_2.
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Andrew J. Kassick, Heather N. Allen, Saigopalakrishna S. Yerneni, Fathima Pary, Marina Kovaliov, Cooper Cheng, Marco Pravetoni, Nestor D. Tomycz, Donald M. Whiting, Toby L. Nelson, Michael Feasel, Phil G. Campbell, Benedict Kolber & Saadyah Averick. (2019) Covalent Poly(lactic acid) Nanoparticles for the Sustained Delivery of Naloxone. ACS Applied Bio Materials 2:8, pages 3418-3428.
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Francis Melaragni, Carly Levy, Jennifer Pedrazzi & Merissa Andersen. (2019) Assessing pharmacists’ readiness to dispense naloxone and counsel on responding to opioid overdoses. Journal of the American Pharmacists Association 59:4, pages 550-554.e2.
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Jeffrey Fudin, Amelia L Persico, Jeffrey J Bettinger & Erica L Wegrzyn. (2019) The state of naloxone: Access amid a public health crisis. Medicine Access @ Point of Care 3, pages 239920261984763.
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S. Mallory Burns, Christopher W. Cunningham & Susan L. Mercer. (2018) DARK Classics in Chemical Neuroscience: Fentanyl. ACS Chemical Neuroscience 9:10, pages 2428-2437.
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Phil Skolnick. (2018) On the front lines of the opioid epidemic: Rescue by naloxone. European Journal of Pharmacology 835, pages 147-153.
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Phil Skolnick. (2018) The Opioid Epidemic: Crisis and Solutions. Annual Review of Pharmacology and Toxicology 58:1, pages 143-159.
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Rachael Rzasa Lynn & JL Galinkin. (2017) Naloxone dosage for opioid reversal: current evidence and clinical implications. Therapeutic Advances in Drug Safety 9:1, pages 63-88.
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Hannah R. Fudin, Jennifer L. Babin, Lisa T. Hong, Jennifer Ku, Alisyn L. May, Alexander Wisner, F. Scott Hall & Sidhartha D. Ray. 2018. A Worldwide Yearly Survey of New Data in Adverse Drug Reactions. A Worldwide Yearly Survey of New Data in Adverse Drug Reactions 29 89 .
BT Gufford, GR Ainslie, JR WhiteJrJr, ME Layton, JM Padowski, GM Pollack & MF Paine. (2017) Comparison of a New Intranasal Naloxone Formulation to Intramuscular Naloxone: Results from Hypothesis-generating Small Clinical Studies. Clinical and Translational Science 10:5, pages 380-386.
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Matthew P. Prekupec, Peter A. Mansky & Michael H. Baumann. (2017) Misuse of Novel Synthetic Opioids: A Deadly New Trend. Journal of Addiction Medicine 11:4, pages 256-265.
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Ida Tylleskar, Arne Kristian Skulberg, Turid Nilsen, Sissel Skarra, Phatsawee Jansook & Ola Dale. (2017) Pharmacokinetics of a new, nasal formulation of naloxone. European Journal of Clinical Pharmacology 73:5, pages 555-562.
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Phillip A. Saccone, Angela M. Lindsey, Robert A. Koeppe, Kathy A. Zelenock, Xia Shao, Phillip Sherman, Carole A. Quesada, James H. Woods & Peter J. H. Scott. (2016) Intranasal Opioid Administration in Rhesus Monkeys: PET Imaging and Antinociception. Journal of Pharmacology and Experimental Therapeutics 359:2, pages 366-373.
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Philip Krieter, Nora Chiang, Shwe Gyaw, Phil Skolnick, Roger Crystal, Fintan Keegan, Julie Aker, Melissa Beck & Jennifer Harris. (2016) Pharmacokinetic Properties and Human Use Characteristics of an FDA-Approved Intranasal Naloxone Product for the Treatment of Opioid Overdose. The Journal of Clinical Pharmacology 56:10, pages 1243-1253.
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John Strang, Rebecca McDonald, Basak Tas & Ed Day. (2016) Clinical provision of improvised nasal naloxone without experimental testing and without regulatory approval: imaginative shortcut or dangerous bypass of essential safety procedures?. Addiction 111:4, pages 574-582.
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Marco L.A. Sivilotti. (2016) Flumazenil, naloxone and the ‘coma cocktail’. British Journal of Clinical Pharmacology 81:3, pages 428-436.
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Eric J. Lavonas, Ian R. Drennan, Andrea Gabrielli, Alan C. Heffner, Christopher O. Hoyte, Aaron M. Orkin, Kelly N. Sawyer & Michael W. Donnino. (2015) Part 10: Special Circumstances of Resuscitation. Circulation 132:18_suppl_2.
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. (2015) Fentanyl. Reactions Weekly 1558:1, pages 86-86.
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Robert S. Hoffman. (2014) Inadequate pain control versus opioid abuse: It is time for the pendulum to swing. American Journal of Health-System Pharmacy 71:18, pages 1537-1537.
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