Risk Factors of Pawasauskas et al for Naloxone Use to Reverse Oversedation or Respiratory Depression in a Hospitalized Patient

 

Patient selection: hospitalized patient receiving opiate analgesia

 

Key risk factors for naloxone reversal (odds ratios from 2.4 to 6.0)

(1) renal disease

(2) cardiac disease

(3) history of smoking

(4) respiratory disease

(5) concurrent sedating medication

(6) hepatic disease

 

Other risk factors:

(1) age 60 to 80 years (odds ratio 1.8)

 

Factors reducing the risk:

(1) opioid naïve (odds ratio 0.32)

 

where:

• A person who is opioid naïve often has a good response at a low dose, while an opioid tolerant patient may require higher and repeated doses for the same effect.

• A person with pulmonary disease may be more likely to have respiratory depression. Several of the risk factors would affect opioid metabolism and elimination. Concurrent sedatives would favor oversedation.