Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The pathophysiological role of endorphins in septic shock was studied in a porcine model. Septic shock was induced by the intravenous infusion of live Escherichia coli. Naloxone hydrochloride, an opiate receptor blocker, given during profound septic shock, increased blood concentrations of glucagon and cyclic adenosine monophosphate (cAMP), while BP and cardiac output increased transiently. Heart rate and hepatic glycogen value decreased, but insulin and cortisol levels remained unchanged. In contrast, exogenous morphine injection produced further reduction of BP, increased pulmonary wedge pressure, and increased substance P, while growth hormone level and cardiac output remained unchanged. Neither hormonal nor hemodynamic changes were noted in saline controls. Thus, the endogenous opiates appear partly responsible for the hemodynamic derangements during septic shock, and naloxone is able to reverse such depression, even though the effects are transient and relatively minor when naloxone is given late in the course of septic shock. Endogenous opiates also affect the hormonal homeostasis in shock, and there are indications that this may be mediated by the adenylate cyclase-cAMP system.
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PMID:Endorphins in septic shock: hemodynamic and endocrine effects of an opiate receptor antagonist and agonist. 628 53

Naloxone hydrochloride, a synthetic N-allyl derivative of oxymorphone, is an effective agent for the reversal of the cardiovascular and respiratory depression associated with narcotic and possibly some non-narcotic overdoses. It is essentially a pure narcotic antagonist, is relatively safe, and is a useful diagnostic and therapeutic agent. Due to naloxone's pharmacokinetic profile, a continuous infusion protocol is recommended when prolonged narcotic antagonist effects are required. The complex pharmacodynamics of naloxone, specifically relating to endorphin receptor sites, focus its potential use in a variety of clinical situations as continuing research illustrates the association of endogenous opioid compounds with various disease states.
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PMID:Naloxone. 630 38

Opioids, particularly morphine sulfate and fentanyl, continue to be the most commonly used agents for analgesia. Morphine provides greater sedation, and there is less of a problem with rigidity of the chest wall than with fentanyl. Morphine also has a higher level of tolerance than does fentanyl. Table 2 provides considerations for administration of morphine and fentanyl. Sedation for the relief of pain without analgesia is not acceptable. Sedation and analgesia together may be in the baby's best interest. Before any plan of care is implemented, the baby should be evaluated for need based on the amount of current respiratory support versus spontaneous respiration. There is evidence in the research literature that narcotic administration can be safely carried out in the preterm when using intravenous caffeine simultaneously to offset the risk of apnea. Others state that there really is no safe therapeutic window for narcotic administration in the preterm infant, yet the benefits outweigh the respiratory depressant effect. The complication of respiratory depression can be readily dealt with through the administration of neonatal Narcan via the intramuscular, intratracheal, or intravenous routes.
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PMID:Research utilization: pharmacologic management of neonatal pain. 778 25

Heroin overdose is a major cause of death among heroin users, and often occurs in the company of other users. However, sudden death after injection is rare, giving ample opportunity for intervention. Naloxone hydrochloride, an injectable opioid antagonist which reverses the respiratory depression, sedation and hypotension associated with opioids, has long been used to treat opioid overdose. Experts have suggested that, as part of a comprehensive overdose prevention strategy, naloxone should be provided to heroin users for peer administration after an overdose. A trial could be conducted to determine whether this intervention improves the management of overdose or results in a net increase in harm (by undermining existing prevention strategies, precipitating naloxone-related complications, or resulting in riskier heroin use).
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PMID:Should we conduct a trial of distributing naloxone to heroin users for peer administration to prevent fatal overdose? 1113 Mar 52

A 46-year-old woman presented to the Emergency Department with lethargy and respiratory depression after ingesting methadone. Initial oxygen saturation of 61% on room air did not improve with supplemental oxygenation. As venous access was initially unobtainable, naloxone was administered by nebulizer. Within 5 min oxygen saturation was 100% and mental status was normal. The patient did not develop severe withdrawal symptoms. Naloxone hydrochloride has been administered by various routes to treat opioid toxicity. Our report describes the successful use of nebulized naloxone for methadone toxicity.
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PMID:Nebulized naloxone gently and effectively reverses methadone intoxication. 1260 50

This article uses a case study to demonstrate the proper use of Narcan (naloxone hydrochloride injection, USP) for the reversal of the effects of opiates which can occur during moderate or "conscious" sedation for procedures in the endoscopy setting. Alternative treatments for the sedation, hypotension, and respiratory depression are discussed, as are instructions and rationale for partial reversal. Guidelines to ensure patient safety are also presented.
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PMID:Narcan use in the endoscopy lab: an important component of patient safety. 1507 60

Results of a study indicate that significant respiratory depression can be produced by the intravenous administration of narcotics in the anesthetic management of oral surgery patients. Naloxone hydrochloride reversed this reaction in all instances. Naloxone is a unique narcotic antagonist in that it does not possess agonistic properties of its own, it is effective in reversing respiratory depression resulting from all commonly used narcotics and narcotic antagonists, it causes no undesirable side effects, and it acts as a placebo when administered to a patient who has not had a narcotic. The use of naloxone should be considered when a potent narcotic is administered to an ambulatory patient.
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PMID:Intravenous narcotic antagonists in ambulatory oral surgery. 1959 79

Naloxone hydrochloride is an agent capable of antagonizing respiratory depression and analgesic actions which are inherent to the opioid by competitively acting at opioid receptors. It greatly contributed to basic research on antagonistic action of opioid receptors due to its high affinity to opioid receptors, in particular, micro-receptor. Naloxone has been recommended as an analeptic agent at a guideline level for patients with revealed or suspicious opioid addiction. Further, it has also been used as a preventive and treatment agent for spinal cord ischemia. Moreover, even though it has been confirmed in 1980's that naloxone has vasopressor effect in septic shock, further clinical trials are required for its wide clinical application.
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PMID:[Naloxone]. 2343 88


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