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Naloxone can swiftly help restore respiration and preserve the life of an opioid overdose victim. Naloxone is a harmless medicine that emergency medical workers and other responders commonly use to avoid fatal opioid overdoses. Naloxone is an opioid receptor antagonist, which means it binds to opioid receptors and prevents or negates the actions of other opioids. The use of naloxone quickly counteracts the effects of opioid medications, restoring normal breathing. It can be given via injection or as a saline solution. Naloxone distribution programs provide naloxone supplies to opiate addicts, their friends and relatives, and anyone who may be in a position to save someone in danger of an opioid overdose. In this paper, patient-specific counseling points regarding the use of naloxone are provided to treat potential opioid overdose of the clients in the future.
The first patient who needs advice is Karen, seven months pregnant, who takes methadone for chronic pain. According to Jordan and Morrisonponce (2022), “a small initial dose, usually 0.04 mg to 0.1 mg IV, is recommended in opioid-dependent patients with symptoms of opioid overdose to avoid opioid withdrawal symptoms” (para. 6). Moreover, the authors specify that individuals with breathing issues due to methadone may benefit from a continuous flow of Naloxone. Namely, two-thirds of the initial effective dosage of Naloxone can be administered as a bolus every 60 minutes, or half of the initial bolus dose can be used 15 minutes after commencing the continuous infusion (Jordan and Morrisonponce, 2022).
Next, Naloxone can be used safely to treat opioid overdose in pregnant women. However, to prevent causing acute opioid abstinence, which may induce fetal distress, the woman should use the lowest effective dose to sustain spontaneous respiratory rate (North Carolina Pregnancy & Opioid Exposure Project., n.d.). Thus, the repeat dosing interval for Karen should be in accordance with the guidelines for methadone overdose, considering the small initial dosage.
The next patients are Raj, who takes methadone for opioid replacement, and a 16-year-old partner who injects heroin. For the partner, pediatric dosing is recommended. According to Pammett (n.d.), pediatric treatment includes the exact dosing of an adult, which means that there are no alternations. As for Raj, Naloxone must be administered slowly because methadone has a substantially longer half-life than naloxone. As a result, the patient should be carefully watched for at least six to twelve hours (Jordan and Morrisonponce, 2022, para. 22). Vital signs, especially pulse oximetry, should be followed until the patient fully recovers. Even after correcting respiratory depression, the patient should be watched for at least six to twelve hours.
The last patients under discussion are Mel, who takes Suboxone films, and Ivan, who takes Oxycontin tablets. In the case of Mel, prescription naloxone is recommended for the immediate treatment of opioid overdose while starting or renewing therapy with Suboxone sublingual film. Due to the lengthy duration of action of Suboxone sublingual film, higher than usual dosages and repeated administration of naloxone may be required, from 0.5 mg to 1 mg (Suboxone Prescribing Information, 2022, p. 4). As for Ivan, to prevent the recurrence of toxicity and respiratory depression, IV dosages or continuous infusions are used for Oxycontin overdoses (Rzasa L. R., Galinkin, J., 2018). Thus, the patients are prescribed larger doses of naloxone for the adjustment to long effects and toxicity of their medications.
References
Jordan, M. R., Morrisonponce, D. (2022) Naloxone. National Library of Medicine. Web.
North Carolina Pregnancy & Opioid Exposure Project. (n.d.). Overview of Pregnancy and Opioid Exposure. Web.
Pammett, R. (n.d.). Naloxone for Opioid Overdose – Virtual Q&A. Canadian Pharmacist Association. Web.
Rzasa L. R., Galinkin, J. (2018). Naloxone dosage for opioid reversal: Current evidence and clinical implications. Therapeutic Advances in Drug Safety, 9(1). Web.
Suboxone Prescribing Information. (2022). Indivior PLC. Web.
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