Il naloxone è un farmaco di scelta nel trattamento della depressione respiratoria causata da narcotici, dagli oppiacei, dalla morfina e dei suoi succedanei sintetici.
Il naloxone non ha effetto farmacologico nei soggetti che non hanno ricevuto oppiacei, morfina o succedanei sintetici; il naloxone è un antagonista “puro” nel senso che esso non ha alcun effetto agonistico (di tipo morfina); la sua azione si spiega con lo spiazzamento dell’agonista dai recettori specifici. Dopo iniezione endovenosa, l’azione antagonista della morfina inizia 2 minuti e dura 30-45 minuti; dato che l’azione di alcuni narcotici può essere più lunga, si deve sorvegliare il paziente per 24 ore ed a volte è necessario ripetere la somministrazione.
Indicazioni
Trattamento della depressione respiratoria causata da morfina o da altri narcotici. Il naloxone non ha alcun effetto nella depressione respiratoria dovuta altre cause. Viene utilizzato durante gli interventi chirurgici o nel trattamento del dolore. Il farmaco può anche essere utilizzato nel trattamento della depressione post-operatoria indotta da stupefacenti.
Posologia
La dose di naloxone generalmente è di 0,4 mg per via endovenosa (o intramuscolare se si ha difficoltà per l’inoculazione endovenosa) che si può ripetere 1-2 volte a 3 minuti di intervallo.
Precauzioni
Somministrazione prudente a soggetti che si suppone essere tossicomani, dal momento che il naloxone può provocare una sindrome di astinenza grave in caso di dipendenza dai narcotici.
Controindicazioni
Ipersensibilità nota al naloxone
Dipendenza da morfina o dai suoi succedanei senza depressione respiratoria.
Effetti secondari
Eccitazione
Comparsa del dolore (in caso di somministrazione postoperatoria)
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