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Emergency Medicine > Narcan > Flashcards

Narcan Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

what is Narcan aka

A

naloxone

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2
Q

where do you get naloxone?

A

depends on the state (ran by the state)

  1. check the health department first
  2. any quick recovery program (roll is to find the individual that OD and provide services to those individuals)
  3. Pharmacy (but costs money and is not always covered by insurance)
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3
Q

where is narcan stored

A

try not to get too cold (freezes liquid) or hot (can breakdown the chemical and it may no longer work)

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4
Q

Narcan MOA

A

Narcan competes for opioid receptor, kicks it off the receptor or blocks it

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5
Q

what are the opioids and what forms do they come/hide in?

A

Fentanyl (worst now) +/- xylazine or fentanyl analogues
Heroine
Carfentanil
Cocaine being laced with fentanyl
Vape pins with fentanyl
Fake pills that look like other things

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6
Q

how much stronger is fentanyl then morphine or heroine? What about carfentanil?

A

depends on the dose, but most commonly
100x morphine
50x heroine
1/100th of carfetnil

Carfetnil is the WORST

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7
Q

if someone is not breathing well, how do they appear and other symptoms of OD

A

cyanotic first
gurgle (death rattle)
cannot wake
also no responsiveness that is not

watch breathing - if 10 sec w/out breath they are in trouble

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8
Q

what are the other opioid narcan

A

naltrexone (not indicated in OD because it is not too quick of onset)

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9
Q

nalophene lasts how long?

A

nalophene lasts like 12 hours

need to have a prescription most often

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10
Q

what happens if you give only one dose of nalaxone

A

they will still feel awful

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11
Q

t/f you should try to shock someone into breathing for OD?

A

False!

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12
Q

If you do not have narcan, what should you do

A

call 911
rescue breathing

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13
Q

what are the steps to giving narcan

A
  1. flat on back on hard surface
  2. open airway
  3. call 911 (will report to pharm and poison control)
  4. adminster 1st dose of narcan
  5. rescue breathing with CPR shields in between doses
  6. if they have not breathed within 3 minutes, give another dose (no matter the product)
  7. follow this cycle until breathing on own or EMS
  8. If the person begins to breathe/move, go on side in recovery position and then back away (because they will be in fight or flight and VERY disoriented for about 1 min)
  9. stay with the person until EMS or law enforcement arrives
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14
Q

t/f you should restrain an OD patient in the hospital setting

A

false

you may get hit

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15
Q

if someone ODs on dextomethorphan, does narcan work?

A

maybe

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16
Q

what are the SE of nalaxone and when are these seen?

A

withdrawal symptoms will only be seen in some1 with opioid addictions

runny nose
sweating
tachycardia
HTN
shaking
N/V/D
rapid return of pain (if you are using for pain/emotional pain)
agitation or violence
seizure (if multiple drugs like stimulants such as meth)

YOU CANNOT ABUSE NARCAN!!!! Give if you are ever worried

17
Q

what are the types of narcan?

A

nasal spray (3,4,8 mg/0.1mL)
nasal via atomizer (need to put it together, not common anymore)
vial/syringe
IM or SQ

18
Q

what is the only device that needs to be 12 or older for injecting?

A

ZIMHI (5mg injection) because of possible needle stick

19
Q

where is narcan disposed?

A

sharp container if needle
trash if nasal

20
Q

how do you give nasal narcan?

A

Ready to go right after taking out
2 fingers on top
slightly toward the closet ear
push the plunger

repeat each dose and try to alternate nostrils if not clogged
can give as many narcans

21
Q

How to administer ZIMHI

A

take out of case
pull off the cap
you will see a needle
straght into the leg
push in the plunger hold for 5 seconds
pull out
push up the notch that covers the needle
put the needle back into the container
throw into a sharps container

can put over clothing, but may be difficult

22
Q

what to do if an OD is in a child

A

Same as anything else!

all narcan is approved
OPVI is 12 and older it is the only one (probably fine, but not FDA approved yet)

23
Q

Legal protection of narcan

A

only not protected if ill intent

if you are sus and use in good faith and call 911, you are covered by the law
if you think it was something else and you have narcan on you, you are covered by the law

they will arrest everyone else in the house that did not call 911 (leave asap)

24
Q

atomizer administration

A

take off both ends of the applicator
needle is inside that punctures the med
pop off purple clamp and the rubber piece goes in until resistance
then put on atomizer on the other end
spray half into each nostril
do not reuse the atomizer

Emergency Medicine (14 decks)

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