Opioid overdose Flashcards
1
Q
MOA of opioids
A
- acts centrally
- mu, kappa & delta
- affects breathing
- CYP2D6 metabolism
2
Q
Presentation of opioid overdose
A
- dec mental status
- pinpoint pupils
- dec bowel sounds
- dec respiration
3
Q
Management of opioid overdose
A
- admin antidote: Naloxone
OR - protect airway
4
Q
Naloxone intranasal clinical pearls
A
longer duration of action and slower onset
5
Q
Naloxone dose for non-opioid dep patients
A
0.4 MG IV
6
Q
Naloxone dose for opioid dependent patients
A
0.04 mg IV and titrate to dose
- avoids acute w/drawal
7
Q
Naloxone dose for bystanders
A
IM 2 mg, IN 4 mg
8
Q
Naloxone induced pulmonary edema MOA and s/s
A
- adrengic response, catecholamine surge
- shift in blood v to pulmonary vasculature
- pulmonary vasoconstriction, HTN, and fluid leakage into lungs
- s/s: tachycardia, tachypnea, HTN
9
Q
Treatment and prevention for naloxone induced pulmonary edema
A
Nitroglycerin, diuretics, positive pressure ventilation
- prevent with small doses/ titration of naloxone
9
Q
Loperamide as Opioid toxidrome (moa, s/s, dose)
A
- MOA: crosses BBB, eliminated by PGP
- patients take pgp inhs (ex. PPIs) to enhance effects
- S/S: overdose & severe cardiac arrhythmias
- Dose: 30-200 mg
10
Q
how to manage loperamide induced opioid overdose
A
- Naloxone for resp dep
- IV mag, Na Bicarb, IV isoproterenol, transcutaneous pacing for cardiac disturbances
- CPR and ACLS
11
Q
How to dose Naloxone IV
A
give 1/2 effective dose bolus load, 2/3 effective do\se as maintenance
