Buprenorphine

Question 1

Buprenorphine Trade Name

Answer 1

(Buprenex)
(Not carried in Danbury)
(Added to CT Protocols 12.2023)

Question 2

Buprenorphine Classification

Answer 2

Medscape:
Opioid Analgesic; Opioid Partial Agonist

Question 3

Buprenorphine Mechanism

Answer 3

Medscape:
Semisynthetic narcotic mixed agonist-antagonist analgesic; exerts agonistic effects at mu and delta opioid receptors in CNS and antagonistic effects at kappa opioid receptor

Question 4

Buprenorphine Onset of Action

Answer 4

Medscape: 15 min (IM); ~1 hr (IV)

Question 5

Buprenorphine Duration of Action

Answer 5

Medscape: >6 hr (IM)

Question 6

Buprenorphine Indications

Answer 6

CT Protocols:
2.20A Poison/overdose/substance use disorder
Protocol Change adds buprenorphine for management of moderate to severe opioid withdrawal post-naloxone administration.

The following procedures are authorized for patients whom have overdosed on opioids AND received naloxone by EMS providers or bystanders AND meet criteria.

Question 7

Buprenorphine Contraindications

Answer 7

CT Protocols:
This procedure may only be performed by Paramedic providers whom have completed buprenorphine administration training approved by their Sponsor Hospital.

1) Assess the patient for exclusion criteria:
* Age <18
* Altered mental status or lack of medical decision-making capacity
* Severe Medical Illness
* Pregnant
* Taken any methadone within the past 10 days

Question 8

Buprenorphine Side Effects/ Precautions/ Comments

Answer 8

Medscape:
Headache (29.1-30%), Pain (18.4-24%), Withdrawal syndrome (18.4-22%),
Insomnia (21.4%), Infection (20%), Asthenia (14%), Back pain (7.8-14%),
Nausea (10-13.6%), Sweating (12-12.6%), Abdominal pain (11.7%), Infection (11.7%), Constipation (7.8-11%)

Question 9

Buprenorphine Adult Dose

Answer 9

CT Protocols:
Patient eligible and agrees to Buprenorphine treatment
Give water to moisten mucous membranes
Administer 16 mg SL Buprenorphine
Reassess COWS Score after 10 minutes
If COWS improved, maintain supportive care
If COWS worsened or not improved, administer additional 8 mg SL
Supportive care. Treat nausea/vomiting per Protocol 2.14
Recommend transport and initiate referral procedure
MAX DOSE 24 MG BUPRENORPHINE PER ENCOUNTER

Question 10

Buprenorphine Pediatric Dose

Answer 10

CT Protocols:
Not in CT Protocols for Pediatric

Question 11

Buprenorphine
Max Dose Adult (Pediatric)

Answer 11

MAX DOSE 24 MG BUPRENORPHINE PER ENCOUNTER

Question 12

Buprenorphine Routes of Administration

Answer 12

SL Per Protocols, IV/IM

Question 13

Buprenorphine How Supplied

Answer 13

8mg SL Tablet