Put It in the Air? Nebulized Opioids in the Emergency Department.

Autor: Bailey AM; Department of Pharmacy Services, University of Kentucky HealthCare, University of Kentucky College of Pharmacy, Lexington (Dr Bailey); and Department of Clinical Pharmacy and Outcomes Sciences, College of Pharmacy, University of South Carolina, Columbia (Dr Weant)., Weant KA
Jazyk: angličtina
Zdroj: Advanced emergency nursing journal [Adv Emerg Nurs J] 2023 Oct-Dec 01; Vol. 45 (4), pp. 260-269.
DOI: 10.1097/TME.0000000000000480
Abstrakt: The emergency department (ED) is a frequent utilizer of alternative routes of medication administration (e.g., intranasal) for a variety of indications. Over the last several years, investigations into the use of medications via the nebulization route have greatly increased, with varying degrees of efficacy identified. This route has multiple theoretical advantages. Medications affecting bronchopulmonary function or secretions can be administered directly to the site of action, possibly utilizing a lower dose and hence minimizing side effects. It is also possible to have a faster onset of action compared with other routes, given the enhanced surface area for absorption. One group of medications that has been explored via this route of administration, and is frequently administered in EDs across the nation, is opioids, most notably fentanyl, hydromorphone, and morphine. However multiple questions exist regarding the implementation of these therapies via this route, including efficacy, dosing, and the functional aspects of medication administration that are more complex than that of more traditional routes. The intent of this review is to explore the supporting literature behind the use of nebulized opioids, most specifically fentanyl, hydromorphone, and morphine, in the ED for the treatment of acute pain presentations and provide the most up-to-date guidance for practitioners.
Competing Interests: Disclosure: The authors report no conflicts of interest.
(Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze: MEDLINE