CNS Depressant Poisoning/Overdose Flashcards
Progressive doses of naloxone are given in ___ minute intervals
3
When administering naloxone, titrating IV dose _____ (range) mg to target re-establishing respiration, circulation and airway control is often safer than giving higher doses initially
0.1-0.4
Naloxone dosing for pediatric patients is ___ mg/kg to a maximum of ___ mg
0.1 mg/kg to a maximum of 0.4mg
note that any child with a mass of 4kg (8.8lb) or greater will receive the full 0.4mg dose of naloxone. Cases where titrated doses for pediatric patients occur (i.e. non-neonatal patients with a mass less than 4kg) will be exceedingly rare
The maximum total dose of naloxone to be given in the pediatric population is ___mg
2.0mg
The maximum total dose of naloxone to be given in the adult population is ___mg
0.4 + 0.4 + 0.8 + 2.0 = 3.6mg
individual doses to be given at 3 minute intervals
The maximum volume of medication to be injected into the vastus lateralis muscle is ___ mL
2.0
Adverse effects of naloxone administration may include: (5 total)
- Reversal of narcotic effect and combativeness
- Signs and symptoms of severe drug withdrawal
- Hypotension, hypertension
- Nausea and vomiting, sweating, tachycardia
- Ventricular fibrillation, asystole
Dosing recommendations are _____ (the same / different) for IV and IM naloxone administration
The same
_____ antidepressants are a common cause of CNS depressant overdose which is time critical and may require treatment with sodium bicarbonate or midazolam.
TriCyclic (TCA)
TCA overdoses may be best managed by ACP/CCP practitioners if these resources are available in a timely fashion
_____ is a CNS depressant which may cause a characteristic presentation of rapidly fluctuating states from combative to unresponsive with respiratory depression
GHB
For the purposes of naloxone administration, pediatric patients are considered to be ___ years old (age range)
<12
Naloxone is _____ (often / rarely) not required in opioid overdose
often
Naloxone should only be given if the respiratory rate is depressed (<10/min) and there is altered LOC not responding to stimulation
The maximum dose of naloxone to be delivered in a single push by PCP-level practitioners is ___ mg
2.0
Doses of this quantity are delivered as the last part of a progressive and staged dosing approach (0.4,0.4,0.8,2.0mg) or as an initial dose in cardiac arrest with suspected opioid overdose
Contraindications for naloxone administration are __________ and __________
Allergy or known hypersensitivity to naloxone and neonatal patients
Naloxone should initially delivered ___ (route) to provide a smoother emergence
IM/SC
What level of license is required to administer a 5th dose of 4mg naloxone or a 6th dose of 10mg naloxone with clinicall consult?
ACP/CCP
The goals of care in CNS depressant overdose are primary airway management, adequate oxygenation, and __________
support of ventilation and transport
note that naloxone administration is not a goal of care and should instead be considered an adjunct to the primary goals of care
Naloxone administration _____ (is / is not) contraindicated in neonates
is
The dosing progression for naloxone in suspected opioid overdose is ___, ___, ___, and then ___ (doses in mg)
0.4, 0.4, 0.8, 2.0
The goals of care in CNS depressant overdose are primary airway management, __________, and support of ventilation and transport.
adequate oxygenation
note that naloxone administration is not a goal of care and should instead be considered an adjunct to the primary goals of care
The preferred initial route and dose for naloxone administration in cardiac arrest with a suspected etiology of opioid overdose is __________
2.0mg IV
Naloxone should only be given if the respiratory rate is _____ (range) breaths/min and there is altered LOC not responding to stimulation
<10
The maximum volume of medication to be injected into the deltoid muscle is ___ mL
1.0
In CNS depression with suspected opioid overdose etiology that is refractory to treatment, other correctable causes of ALOC may be considered, such as ______.
hypoglycemia
The goals of care in CNS depressant overdose are __________, adequate oxygenation, and support of ventilation and transport.
primary airway management
note that naloxone administration is not a goal of care and should instead be considered an adjunct to the primary goals of care
