naloxone versus naltrexone

[aashkab]

Hi guys,

I've seen in several of the questions that you can use naloxone OR naltrexone for acute opiod poisoning. I learned it though as using naloxone ONLY in the acute setting while using naltrexone to help with alcohol/opiod long term dependence.

For example, UWORLD has a question where in one of the answer choice explanations it states "naloxone OR naltrexone."

Thanks

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[vr123]

Hi guys,

I've seen in several of the questions that you can use naloxone OR naltrexone for acute opiod poisoning. I learned it though as using naloxone ONLY in the acute setting while using naltrexone to help with alcohol/opiod long term dependence.

For example, UWORLD has a question where in one of the answer choice explanations it states "naloxone OR naltrexone."

Thanks

technically both could be used, but naltrexone is longer acting, so it is better for long term dependence and naloxone is better for emergencies.

 

[knuckles]

thank god the longer word is longer acting, for memory sake

 

[Xtrasystolic]

Its been a few weeks and a few drinking binges since my step 1 so please correct me if I'm wrong. Naltrexone is possible PO and is longer acting. Meaning it is more apt for management of cravings than overdose.

 

[dozitgetchahi]

Basic differences/issues:

- Naloxone is shorter acting than naltrexone. Thus, if somebody comes into an ER having OD'd on a long-acting opiate/opioid, it may take several doses of naloxone over the course of many hours to fully antagonize the actions of the opiate/opioid. On the other hand, it may only take one dose of naltrexone to antagonize the opioid adequately. Furthermore, naltrexone's longer half-life makes it more suitable for long-term treatment of cravings (in fact, it's FDA approved for controlling both opioid and alcohol abuse/cravings).

- Naltrexone has a greater likelihood of causing liver injury.

 

[Guyton Killah]

2 hours vs 2 days 🙂

 

[leviathan]

From my experience as a paramedic, we only used naloxone (Narcan) and I never saw any MD use naltrexone. I don't think they'd ever put both together as answer options, but if they did, I'd go with naloxone.

This is a good Q to look up though, because you do have to deal with the issue of its short half-life, whereas with naltrexone it seems you wouldn't.

 

[kaylamclfy]

naloxone: rapid onset, short acting, not bioavailable po (no effect when eaten or dissolved sublingual), bioavailable IV (blocks opioid effect when injected, this is why it's included w buprenorphine to make Suboxone)

naltrexone: delayed onset, relatively longer acting (but still not very long acting in general), bioavailable po (comes in tablets)

 

[rjr020]

I'm on my psych rotation right now:

Naloxone is for acute opioid overdose. You give that to keep the person from dying in the ambulance or ED.

Naltrexone is a long term treatment to help achieve abstinence from opioids and/or alcohol, used as an outpatient treatment for highly motivated patients (because if you want to use, you can choose not to take it, and go get high or drunk). Naltrexone decreases opioid cravings but you can still get high. For alcohol it decreases the craving and the effect, so you can drink without getting drunk. DON'T GIVE TO SOMEONE WHO IS CURRENTLY HIGH because it precipitates withdrawal, which is very crappy for the patient. Naloxone keeps them from dying without making the next few hours totally miserable.

Use Buprenorphine to treat symptoms once they are already withdrawing.

Hi guys,

I've seen in several of the questions that you can use naloxone OR naltrexone for acute opiod poisoning. I learned it though as using naloxone ONLY in the acute setting while using naltrexone to help with alcohol/opiod long term dependence.

For example, UWORLD has a question where in one of the answer choice explanations it states "naloxone OR naltrexone."

Thanks

Hi guys,

I've seen in several of the questions that you can use naloxone OR naltrexone for acute opiod poisoning. I learned it though as using naloxone ONLY in the acute setting while using naltrexone to help with alcohol/opiod long term dependence.

For example, UWORLD has a question where in one of the answer choice explanations it states "naloxone OR naltrexone."

Thanks

 

[valbethw @yahoo.com]

Also remember that LOW dosage Naldroxone is a totally different animal. It's use is increasing for treatment of such things as cancer, MS and fibromyalgia.

 

[chizledfrmstone]

Also remember that LOW dosage Naldroxone is a totally different animal. It's use is increasing for treatment of such things as cancer, MS and fibromyalgia.

What is naldroxone?

If a patient comes in OD on opioids they're not likely to swallow a pill right? So I thought the reasoning was you give them naloxone because it's IV.

 

[DrPicard]

Naloxone is given during acute opioid intoxication for reversal of respiratory depression. Opioids depress the CO2 drive for respiration, so giving O2 to such a person can be dangerous.

Naltrexone is for long term maintenance only; not for acute control.

Thats how I understand it anyway!