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Pharmacologic and Clinical Considerations of Nalmefene, a Long Duration Opioid Antagonist, in Opioid Overdose

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Department of Psychiatry and Behavioral Medicine, Louisiana State University Health Shreveport, Shreveport, LA 71103, USA
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School of Medicine, Louisiana State University Health New Orleans, New Orleans, LA 70112, USA
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School of Medicine, Louisiana State University Health Shreveport, Shreveport, LA 71106, USA
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School of Medicine, Medical College of Wisconsin, Milwaukee, WI 53226, USA
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Department of Psychology, University of New Haven, West Haven, CT 06516, USA
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Department of Anesthesiology, Louisiana State University Shreveport, Shreveport, LA 71103, USA
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Department of Pharmacy Practice, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Stockton, CA 95211, USA
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Author to whom correspondence should be addressed.
Academic Editor: Domenico De Berardis
Psychiatry Int. 2021, 2(4), 365-378; https://doi.org/10.3390/psychiatryint2040028
Received: 23 August 2021 / Revised: 29 September 2021 / Accepted: 8 October 2021 / Published: 14 October 2021
Opioid use disorder is a well-established and growing problem in the United States. It is responsible for both psychosocial and physical damage to the affected individuals with a significant mortality rate. Given both the medical and non-medical consequences of this epidemic, it is important to understand the current treatments and approaches to opioid use disorder and acute opioid overdose. Naloxone is a competitive mu-opioid receptor antagonist that is used for the reversal of opioid intoxication. When given intravenously, naloxone has an onset of action of approximately 2 min with a duration of action of 60–90 min. Related to its empirical dosing and short duration of action, frequent monitoring of the patient is required so that the effects of opioid toxicity, namely respiratory depression, do not return to wreak havoc. Nalmefene is a pure opioid antagonist structurally similar to naltrexone that can serve as an alternative antidote for reversing respiratory depression associated with acute opioid overdose. Nalmefene is also known as 6-methylene naltrexone. Its main features of interest are its prolonged duration of action that surpasses most opioids and its ability to serve as an antidote for acute opioid overdose. This can be pivotal in reducing healthcare costs, increasing patient satisfaction, and redistributing the time that healthcare staff spend monitoring opioid overdose patients given naloxone. View Full-Text
Keywords: nalmefene; opioid overdose; naloxone; harm reduction; antidote nalmefene; opioid overdose; naloxone; harm reduction; antidote
MDPI and ACS Style

Edinoff, A.N.; Nix, C.A.; Reed, T.D.; Bozner, E.M.; Alvarez, M.R.; Fuller, M.C.; Anwar, F.; Cornett, E.M.; Kaye, A.M.; Kaye, A.D. Pharmacologic and Clinical Considerations of Nalmefene, a Long Duration Opioid Antagonist, in Opioid Overdose. Psychiatry Int. 2021, 2, 365-378. https://doi.org/10.3390/psychiatryint2040028

AMA Style

Edinoff AN, Nix CA, Reed TD, Bozner EM, Alvarez MR, Fuller MC, Anwar F, Cornett EM, Kaye AM, Kaye AD. Pharmacologic and Clinical Considerations of Nalmefene, a Long Duration Opioid Antagonist, in Opioid Overdose. Psychiatry International. 2021; 2(4):365-378. https://doi.org/10.3390/psychiatryint2040028

Chicago/Turabian Style

Edinoff, Amber N., Catherine A. Nix, Tanner D. Reed, Elizabeth M. Bozner, Mark R. Alvarez, Mitchell C. Fuller, Fatimah Anwar, Elyse M. Cornett, Adam M. Kaye, and Alan D. Kaye 2021. "Pharmacologic and Clinical Considerations of Nalmefene, a Long Duration Opioid Antagonist, in Opioid Overdose" Psychiatry International 2, no. 4: 365-378. https://doi.org/10.3390/psychiatryint2040028

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