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Intranasal Butorphanol‐Induced Apraxia Reversed by Naloxone
Author(s) -
GoraHarper Mary Lea,
Sunahara Janice E,
Gray Mary S.
Publication year - 1995
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1002/j.1875-9114.1995.tb02901.x
Subject(s) - butorphanol , somnolence , (+) naloxone , medicine , anesthesia , vomiting , sore throat , opioid antagonist , nasal administration , nausea , adverse effect , psychology , opioid , pharmacology , receptor
Intranasal butorphanol is an opioid agonist‐antagonist that is effective for the treatment of acute pain. Common adverse effects associated with the agent are somnolence, dizziness, nausea, and vomiting; they are readily reversed with naloxone. A patient developed signs and symptoms consistent with apraxia after a single dose of intranasal butorphanol. She was mentally alert, but she was unable to move or speak despite normal muscle tone and reflex movements. When she attempted to speak she had no voluntary control. At the emergency room she was administered naloxone 2 mg intramuscularly which resulted in complete reversal of the symptoms in a short time. No other published cases describe these findings with butorphanol. Health care professionals should be aware that patients who are prescribed intranasal butorphanol, even in typical doses, may be at risk for such a reaction. This is important because, unlike the injectable formulation, the intranasal product is primarily used in the outpatient setting.