OPIOID TOXICITY Flashcards
OPIOID TOXICITY AND POISONING
ABCDE(f)G:
Lifethreatening respiratory depression:
Support ventilation
Naloxone 0.4 mg IV / IN / IM
Peds: 0.1 mg / kg (full reversal) IV / IM / ET (max 2 mg); 0.001 - 0.01 mg / kg (partial) IV
Onset 1 min, Duration 30-60 min
Repeat dosing Naloxone 0.4 mg - 2 mg IV / IN / IM PRN, 10 mg Max Dose
Naloxone infusion (mg/hr) at 2/3 initial effective dose (total dose in 1 hr)
Naloxone induced withdrawl:
To avoid withdrawl, <0.05 mg IV PRN
Toxidrome:
CNS depression, respiratory depression, +/-Miosis
Labs:
Add CK
Management / Disposition:
Supplemental 02, Sp02 > 92%
Monitoring: mental status, respiratory rate pupils
No naloxone: Observe for 4-6 hours, discharge upon return to baseline, longer if longer acting opioid
Naloxone: Observe for min 1 hr after last dose and return to baseline
Discharge with naloxone, prescription for naloxone, suboxone, referral to substance abuse program
