Opioid Toxicity MD

Question 1

What are the indications?

Answer 1

Altered LOC
and
RESP depression
and
inability to adequately ventilate OR persistent need to assist ventilations
AND suspected opioid OD

Question 2

What are the conditions for naloxone?

Answer 2

> =24hrs
LOA - altered
<10breaths per min

Question 3

What are the contraindications to naloxone?

Answer 3

ax or sensitivity

Question 4

What is the TREATMENT for naloxone? (routes, doses, max, dosing interval and max # of doses)

Answer 4

IV
up to 0.4mg
max- 0.4mg
dosing int.- 5 mins
max doses #- 3

IM
0.4mg
max- 0.4mg
dosing int.- 5 mins
max doses #- 3

IN
up to 2-4mg
max- 2-4mg
dosing int.- 5 mins
max doses #- 3

SQ
up to 0.8mg
max- 0.8mg
dosing int.- 5 mins
max doses #- 3

Question 5

Why is IV the preferred route?

Answer 5

so medics can titrate and control how much of the drug is administered in order to restore pt/s respiratory status and keep themselves safe lol

Question 6

What are some clinical considerations that we need to consider for this directive?

Answer 6

IV adminstrations only for PCP AIV

If no response to initial treatment, consider patching for further doses

GLUCOMETRY should be considered

medics should anticipate combativeness and should protect themselves accordingly, thus the importance of gradual titrating to desired clinical affect
- resp rate >= 10
- adequate airway
- ventilation, not full alertness

Question 7

What is the dangers of naloxone if it is an unknown overdose substance?

Answer 7

• may unmask alternative toxidromes in mixed OD situations (leading to possible seizures, hypertensive crisis etc.)

Question 8

What is the titratration increment for naloxone when giving it IV?

Answer 8

SMALL increments (no value) up to 0.4mg
only restore to resp rate to >=10
consider dilution for easier titration

Question 9

What is your INITIAL PRIORITY when dealing with overdoses?

Answer 9

upfront and aggressive AIRWAY MANAGEMENT!!