In the case report presented on ACEI toxicity what is the proposed mechanism of action of naloxone’s ability to reverse hypotension.
Naloxone promotes the effect of enkephalinase, an enzyme responsible for endogenous opioid degradation (ie beta-endoprhin). Degradation of endogenous opioids inhibit angiotensin II which inhibits vasoconstriction and aldosterone release.
Haluska AD, Davis A, Tarabishy N, Pena ME. Use of Naloxone in Angiotensin-Converting Enzyme Inhibitor Overdose: A Case Report. J Emerg Med. 2023 Mar;64(3):397-399. doi: 10.1016/j.jemermed.2022.12.010. Epub 2023 Mar 15. PMID: 36925439.
Contributed by Hanna Kulbeth, MD PGY2, Emergency Medicine Resident, UF Health Jacksonville, on behalf of the Florida Poison Information Center Network