opioid toxicity

Question 1

what is used in opioid overdose

Answer 1

naloxone

Question 2

indications for naloxone

Answer 2

• opioid toxicity with resp and/ or neuro depression

prefilled syring eused for community bystanders - may be indicated for individuals at high risk of recurrent opioid toxicity - use by someone close to person to prevent death

Question 3

MOA naloxone

Answer 3

• binds to opioid receptors esp mew receptors = competitive antagonists
• no effect if no exogenous opioid - when present, naloxone displaces it from its receptors and reverses it effects.

Question 4

SE naloxone

Answer 4

• opioid withdrawal reaction - pain, restlesness, n and v, dilated pupils, and cold, dry skin with piloerection (cold turkey)

Question 5

be careful using naloxone in which patients

Answer 5

• opioid dependance

- palliative care - use lwoer doses

Question 6

which section do you prescribe naloxone in

Answer 6

Once only

Question 7

how to give naloxone for reversal in hospital

Answer 7

20–400 mcg IV every 2-3mins until satisfactory reversal.

if chronic use and toxic then = smaller incremental doses e.g. 40-100mcg

Question 8

how to give life saving naloxone in community

Answer 8

IM in doses of 400mcg/ 0.4ml of 1mg/ml solution, every 2-3mins till help arrives

Question 9

how long do you monitor for after naloxone is given for reversal

Answer 9

1hr

Question 10

clinical tip

Answer 10

When giving very small doses of naloxone (e.g. 40 micrograms), it is impractical to use the 400 microgram/mL solution that is usually available on the wards. Therefore take 1 mL (400 micrograms) of this solution in a 10-mL syringe and add 9 mL of 0.9% sodium chloride. Label the syringe immediately. The resulting 40-microgram/mL solution can then be administered in more practical 1-mL increments.