This document provides training on the use of intranasal naloxone to respond to opioid overdoses. It describes signs of overdose, how to prepare and administer intranasal naloxone using an atomizer, and legal protections for those who call for emergency help after administering naloxone. The training emphasizes that naloxone reverses the effects of opioids and can prevent injury or death from overdose, so anyone witnessing an unresponsive individual after suspected drug use should contact emergency services and administer naloxone if available.
Narcan nasal spray was approved by the FDA in November 2015 as the first naloxone product that can be administered as a nasal spray to treat opioid overdoses. Its approval was fast-tracked due to the growing problem of opioid overdose deaths in the US. The nasal spray formulation makes naloxone easier for laypeople to use compared to injectable forms. The approval of Narcan nasal spray aims to expand access to naloxone and help reduce opioid overdose deaths.
This document discusses opioid overdose and the use of naloxone to reverse overdoses. It provides statistics on drug-related deaths in the UK and risk factors for overdose. Naloxone is described as a temporary antidote that reverses the effects of opioid overdose by binding to opioid receptors but not activating them. The document outlines how to recognize an overdose, administer naloxone via injection, and the need to still call emergency services. Barriers to naloxone access and potential future developments are mentioned.
This document provides information and instructions for responding to an opioid overdose emergency using naloxone. It begins with an overview of the REVIVE program and training objectives. It then discusses opioid overdoses, how to recognize one, and risk factors. Myths about reversing overdoses are dispelled. The document emphasizes that naloxone is the only effective response and provides step-by-step instructions: check responsiveness and give rescue breaths if needed, call 911, administer naloxone, continue rescue breathing, and give a second dose of naloxone if needed. Proper positioning and calling for emergency help are also described.
Opioids and opiates act on opioid receptors in the brain, spinal cord and gut to reduce pain perception. They can cause respiratory depression, physical dependence and euphoria. Opioid overdose deaths have increased significantly in recent decades. Common signs of overdose include pinpoint pupils, decreased breathing and unconsciousness. History and examination may reveal signs of drug use as well as depressed breathing and mental status. Naloxone is used to reverse effects in an overdose.
This document provides information about distributing naloxone through community pharmacies in British Columbia to prevent opioid overdoses. It discusses how naloxone works, guidelines for take-home naloxone programs, populations that could benefit from access to naloxone, how pharmacies can provide naloxone and education to customers, recommended supplies, pricing, and documentation guidelines. The goal is to increase accessibility to naloxone and empower more people to recognize and respond to opioid overdoses in their community.
This document provides an overview of opioid overdoses and the use of naloxone to treat opioid overdoses. It defines opioids and describes the history of opioids in the US and Massachusetts. It explains that more people in MA now die from opioid overdoses than from car accidents. The document outlines how to assemble and administer nasal naloxone to someone experiencing an opioid overdose. It emphasizes the importance of department policies for storing, using, replacing, and documenting the use of nasal naloxone.
Allergic rhinitis is a common respiratory allergy caused by an immunologic reaction to allergens like dust, pollen, or animal dander. It affects 10-25% of the population. Diagnosis is based on history and symptoms of sneezing, congestion, and runny nose. Treatment includes allergen avoidance, antihistamines, nasal steroids, and immunotherapy. Nursing focuses on education about the condition, medications, and lifestyle modifications to reduce allergen exposure and control symptoms.
Narcan nasal spray was approved by the FDA in November 2015 as the first naloxone product that can be administered as a nasal spray to treat opioid overdoses. Its approval was fast-tracked due to the growing problem of opioid overdose deaths in the US. The nasal spray formulation makes naloxone easier for laypeople to use compared to injectable forms. The approval of Narcan nasal spray aims to expand access to naloxone and help reduce opioid overdose deaths.
This document discusses opioid overdose and the use of naloxone to reverse overdoses. It provides statistics on drug-related deaths in the UK and risk factors for overdose. Naloxone is described as a temporary antidote that reverses the effects of opioid overdose by binding to opioid receptors but not activating them. The document outlines how to recognize an overdose, administer naloxone via injection, and the need to still call emergency services. Barriers to naloxone access and potential future developments are mentioned.
This document provides information and instructions for responding to an opioid overdose emergency using naloxone. It begins with an overview of the REVIVE program and training objectives. It then discusses opioid overdoses, how to recognize one, and risk factors. Myths about reversing overdoses are dispelled. The document emphasizes that naloxone is the only effective response and provides step-by-step instructions: check responsiveness and give rescue breaths if needed, call 911, administer naloxone, continue rescue breathing, and give a second dose of naloxone if needed. Proper positioning and calling for emergency help are also described.
Opioids and opiates act on opioid receptors in the brain, spinal cord and gut to reduce pain perception. They can cause respiratory depression, physical dependence and euphoria. Opioid overdose deaths have increased significantly in recent decades. Common signs of overdose include pinpoint pupils, decreased breathing and unconsciousness. History and examination may reveal signs of drug use as well as depressed breathing and mental status. Naloxone is used to reverse effects in an overdose.
This document provides information about distributing naloxone through community pharmacies in British Columbia to prevent opioid overdoses. It discusses how naloxone works, guidelines for take-home naloxone programs, populations that could benefit from access to naloxone, how pharmacies can provide naloxone and education to customers, recommended supplies, pricing, and documentation guidelines. The goal is to increase accessibility to naloxone and empower more people to recognize and respond to opioid overdoses in their community.
This document provides an overview of opioid overdoses and the use of naloxone to treat opioid overdoses. It defines opioids and describes the history of opioids in the US and Massachusetts. It explains that more people in MA now die from opioid overdoses than from car accidents. The document outlines how to assemble and administer nasal naloxone to someone experiencing an opioid overdose. It emphasizes the importance of department policies for storing, using, replacing, and documenting the use of nasal naloxone.
Allergic rhinitis is a common respiratory allergy caused by an immunologic reaction to allergens like dust, pollen, or animal dander. It affects 10-25% of the population. Diagnosis is based on history and symptoms of sneezing, congestion, and runny nose. Treatment includes allergen avoidance, antihistamines, nasal steroids, and immunotherapy. Nursing focuses on education about the condition, medications, and lifestyle modifications to reduce allergen exposure and control symptoms.
Prescription drugs for the respiratory systemMMARTIN274
VENTOLIN HFA is an albuterol inhaler used to treat bronchospasm during asthma attacks by quickly opening airways. It acts within minutes and lasts 4-6 hours. Possible side effects include paradoxical bronchospasm, cardiovascular effects like changes in pulse or blood pressure, and immediate hypersensitivity reactions. Flonase is a nasal spray containing fluticasone used to treat nasal allergy symptoms. Side effects may include headache, nosebleeds, and vision problems. Ciprofloxacin is an antibiotic used to treat bacterial infections. It may interact with other medications and side effects can include allergic reactions, joint pain, and diarrhea.
The document summarizes updates made to the New York State EMS protocols and policies allowing for basic life support providers to administer intranasal naloxone to patients experiencing an opioid overdose. It discusses the growing problem of prescription opioid overdoses nationally and in New York. The policy change is intended to respond to this public health crisis and is informed by guidelines from organizations like SAMHSA on responding to opioid overdoses.
Ofloxacin 2mg per ml solution for infusion pil, taj pharmaceuticals.Taj Pharma
Ofloxacin 2mg/ml Solution for Infusion, Taj Pharma : Uses, Side Effects, Interactions, Pictures, Warnings, Ofloxacin Dosage & Rx Info | Ofloxacin Uses, Side Effects – Antifungal/ Antibacterial, Ofloxacin 2mg/ml Solution for Infusion: Indications, Side Effects, Warnings, Ofloxacin - Drug Information - Taj Pharma, Ofloxacin dose Taj pharmaceuticals Ofloxacin interactions, Taj Pharmaceutical Ofloxacin contraindications, Ofloxacin price, Ofloxacin , Taj Pharma Ofloxacin 2mg/ml Solution for Infusion, - Taj Pharma . Stay connected to all updated on Ofloxacin Taj Pharmaceuticals Taj pharmaceuticals Hyderabad. Patient Information Leaflets, PIL.
Pharmacology of opthamology. by maghan dasMaghan Das
This document provides information on ocular pharmacology for eye care assistants and technicians. It covers the roles and responsibilities of assistants and technicians, including recording patient information, educating patients, and never working without understanding. It also discusses various types of eye medications like diagnostic agents, therapeutic agents, anti-glaucoma drugs, anti-inflammatory medications, antibiotics, and lubricating drops. Common abbreviations used in ocular prescriptions are defined. Proper administration techniques for eye drops, ointments, and injections are outlined. Potential complications of certain medications are also noted.
This document discusses antihistamines, which are drugs that competitively block the actions of histamine at H1 receptors. It describes the pharmacological actions and effects of first-generation antihistamines, which provide relief from allergy symptoms but often cause sedation as a side effect. Second-generation antihistamines are introduced that have higher H1 selectivity and do not cause sedation. Specific second-generation antihistamines are outlined, including fexofenadine, loratadine, desloratadine, cetirizine, and levocetirizine. Their indications, pharmacokinetics, and advantages over first-generation antihistamines are summarized. The
This document provides summaries of several drug safety issues discussed in the June 2014 issue of Prescriber Update, including:
1) Atomoxetine can cause suicidal ideation and behavior in some patients. Patients taking atomoxetine should be closely monitored for new or worsening depression, agitation or irritability.
2) Zopiclone can cause impairment the day after use that can last over 11 hours, affecting driving ability. Patients should be warned about this risk and zopiclone should only be used short-term.
3) Olanzapine depot injections carry a small risk of post-injection syndrome within 1 hour of injection, requiring monitoring for 2 hours after doses. Symptoms usually resolve within
T abuhadid opioid_abuse_and_withdrawalLaurie Crane
Opioid Abuse and Withdrawal discusses opioid abuse, withdrawal symptoms, medications used for withdrawal like buprenorphine and methadone, and assessing withdrawal severity using the Clinical Opioid Withdrawal Scale (COWS). It explains that short-acting opioids cause withdrawal sooner than long-acting ones. Precipitated withdrawal can occur if withdrawal medications are given before full withdrawal occurs. The document provides a case study to demonstrate accurately using the COWS scale to rate withdrawal severity.
The document discusses poisoning, including what causes poisoning, common symptoms of poisoning, and treatment for poisoning. It states that medications are the most common cause of poisoning, with paracetamol, aspirin, calcium channel blockers, opioids, and tricyclic antidepressants most commonly linked to poisoning. Household products and contaminated food can also sometimes cause poisoning. Young children are at high risk of poisoning because they put things in their mouth without knowing if they are harmful. Symptoms vary but can include nausea, vomiting, drowsiness, and changes in breathing and heart rate. Treatment involves calling for help, checking airways, giving activated charcoal or antidotes, and monitoring in the hospital through blood tests and ECG
The document discusses drugs used to treat allergic rhinitis, cough, and colds. It describes the mechanisms and uses of various classes of drugs including oral and intranasal antihistamines, intranasal glucocorticoids, intranasal cromolyn sodium, decongestants, antitussives, expectorants and mucolytics. It notes risks of rebound congestion from overuse of decongestants and recommends limiting use to 3-5 days to prevent dependency.
This drug combination contains loperamide hydrochloride, which is used to treat diarrhea. Loperamide works by slowing intestinal movement and fluid secretion to allow more time for water absorption. It is well absorbed from the gastrointestinal tract and has a half-life of around 10-14 hours. Common side effects can include abdominal pain, nausea, and vomiting. Loperamide should be used with caution in patients with liver or kidney disease and is not recommended for children under 2 years old.
One Step Clinic is a leading outpatient addiction treatment facility in Ireland. For suitable patients Naltrexone implants are administered as part of a sustained treatment option.
Ibugesic Plus (Generic Ibuprofen and Paracetamol Tablets) The Swiss Pharmacy
Ibugesic Plus contains 2 ingredients: Ibuprofen And Acetaminophen (Paracetamol). This medicine is used for the management of mild to moderate pain and inflammation in conditions such as dysmenorrhoea, headache, including migraine, post-operative pain, dental pain, musculoskeletal and joint disorders, peri-articular disorders and soft tissue disorders (sprains and strains).This combination product works by blocking your body's production of certain natural substances that cause inflammation. This effect helps to decrease swelling, pain, or fever.
This document provides training for EMTs and EMRs on administering naloxone to patients experiencing an opioid overdose. It aims to reduce overdose mortality and morbidity by instructing first responders. The training covers recognizing overdose symptoms, indications and contraindications for naloxone use, possible adverse reactions, proper administration techniques via intranasal spray or intramuscular injection, and the importance of transporting patients for additional care and monitoring after naloxone administration. Responders must be prepared to manage agitated patients and the potential for return of overdose symptoms due to naloxone's shorter duration than opioids.
This document provides an overview and training for a program to train pharmacists in Maryland on responding to opioid overdoses. It begins with introducing the program and providing statistics on the opioid epidemic in Maryland. It then defines harm reduction and discusses recognizing and responding to overdoses, including administering naloxone. The document provides details on naloxone administration and storage/disposal, as well as information for pharmacists on dispensing naloxone. The goal is to equip pharmacists with knowledge to help prevent overdose deaths in their communities.
This document provides training for EMTs and EMRs on administering the opioid antagonist naloxone. It aims to reduce deaths from opioid overdose by instructing first responders. The training covers recognizing and treating opioid overdose, indications and contraindications for naloxone use, possible adverse reactions, and how to prepare and administer naloxone via intramuscular autoinjector or intranasal spray. Responders learn to identify overdose, administer naloxone, manage adverse reactions, and ensure transportation to definitive care.
Naloxone, also known as Narcan, is a medication used to reverse opioid overdoses. It works by blocking opioid receptors in the brain and reversing the life-threatening effects of overdoses from drugs like heroin, morphine, and oxycodone. Signs of an opioid overdose include little or no breathing, blue/grey skin color, and lack of response. If an overdose is suspected, it is important to call 911, administer naloxone, and provide rescue breathing until emergency help arrives. Naloxone is safe and effective for reversing overdoses, but its effects only last 30-90 minutes so continued monitoring is needed.
This document summarizes the management of opioid analgesic overdoses. It notes that opioid overdoses can affect multiple organ systems and disrupt normal pharmacokinetics, prolonging intoxication. It also discusses the increasing rates of opioid prescriptions and overdoses in the US. The classic signs of opioid overdose are described as well as diagnostic considerations. Management involves supporting respiration with a bag-valve mask and administering naloxone to reverse effects. Doses of naloxone are outlined and it is noted that patients may need to be observed for extended periods, especially if long-acting opioids were used, to monitor for recurrent respiratory depression. Potential pitfalls in management are also summarized.
This document provides education and training on opioid overdoses and the use of naloxone for Ohio EMS personnel. It describes the development and uses of naloxone as an opioid antagonist for emergent overdose treatment. It outlines the types of opioids commonly involved in overdoses and their routes of administration. The document then details the signs and symptoms of opioid overdose as well as associated medical complications. It provides information on the mechanisms of naloxone and potential adverse effects upon administration. The document concludes by outlining Ohio EMS protocols for the administration of intranasal naloxone by emergency medical responders and emergency medical technicians under medical director approval and training.
This document provides education and training on opioid overdoses and the use of naloxone for Ohio EMS. It discusses the development and increased demand for naloxone, common opioids and their effects. It outlines administration routes for naloxone and the expansion of Ohio EMS scope of practice to allow EMTs and EMRs to administer intranasal naloxone with medical director approval and training. Potential adverse effects of naloxone administration are also reviewed.
Management of Opioid Analgesic OverdoseSun Yai-Cheng
This document summarizes the management of opioid analgesic overdoses. It notes that opioid overdoses can have life-threatening effects on multiple organ systems. The duration of action varies between opioid formulations and an overdose can prolong intoxication. Prescriptions for opioid analgesics in the US increased 700% from 1997-2007. Opioid overdoses lead to over 27,500 health care facility admissions in 2010. Clinical signs of overdose include respiratory depression, apnea, miosis, and stupor. Naloxone is the antidote and works by reversing opioid receptor activity but has a shorter duration than many opioids. Higher and repeated naloxone doses may be needed for long-acting opioids like
This document discusses overdose prevention and harm reduction strategies. It defines overdose as occurring when a toxic amount of drugs overwhelms the body. It then focuses on opioid overdose, describing signs and symptoms, priority groups at risk, and how to respond by stimulating the person, calling for help, ventilating if needed, administering naloxone, and monitoring the person. It also discusses access to naloxone in Texas, stimulant overdose, and general risk factors. The document promotes harm reduction strategies like avoiding mixing drugs, using less after periods of no use, knowing one's tolerance, and not using alone.
The document discusses opiate intoxication and treatment. It covers the history, physical exam findings, differential diagnosis, management, and complications of opiate overdose. Key signs of overdose include depressed consciousness, respiratory depression, miosis, and fresh needle marks. Treatment involves supportive care, naloxone to reverse effects, activated charcoal if ingestion was recent, and monitoring for complications like withdrawal symptoms, infections from needle use, or acute lung injury.
Prescription drugs for the respiratory systemMMARTIN274
VENTOLIN HFA is an albuterol inhaler used to treat bronchospasm during asthma attacks by quickly opening airways. It acts within minutes and lasts 4-6 hours. Possible side effects include paradoxical bronchospasm, cardiovascular effects like changes in pulse or blood pressure, and immediate hypersensitivity reactions. Flonase is a nasal spray containing fluticasone used to treat nasal allergy symptoms. Side effects may include headache, nosebleeds, and vision problems. Ciprofloxacin is an antibiotic used to treat bacterial infections. It may interact with other medications and side effects can include allergic reactions, joint pain, and diarrhea.
The document summarizes updates made to the New York State EMS protocols and policies allowing for basic life support providers to administer intranasal naloxone to patients experiencing an opioid overdose. It discusses the growing problem of prescription opioid overdoses nationally and in New York. The policy change is intended to respond to this public health crisis and is informed by guidelines from organizations like SAMHSA on responding to opioid overdoses.
Ofloxacin 2mg per ml solution for infusion pil, taj pharmaceuticals.Taj Pharma
Ofloxacin 2mg/ml Solution for Infusion, Taj Pharma : Uses, Side Effects, Interactions, Pictures, Warnings, Ofloxacin Dosage & Rx Info | Ofloxacin Uses, Side Effects – Antifungal/ Antibacterial, Ofloxacin 2mg/ml Solution for Infusion: Indications, Side Effects, Warnings, Ofloxacin - Drug Information - Taj Pharma, Ofloxacin dose Taj pharmaceuticals Ofloxacin interactions, Taj Pharmaceutical Ofloxacin contraindications, Ofloxacin price, Ofloxacin , Taj Pharma Ofloxacin 2mg/ml Solution for Infusion, - Taj Pharma . Stay connected to all updated on Ofloxacin Taj Pharmaceuticals Taj pharmaceuticals Hyderabad. Patient Information Leaflets, PIL.
Pharmacology of opthamology. by maghan dasMaghan Das
This document provides information on ocular pharmacology for eye care assistants and technicians. It covers the roles and responsibilities of assistants and technicians, including recording patient information, educating patients, and never working without understanding. It also discusses various types of eye medications like diagnostic agents, therapeutic agents, anti-glaucoma drugs, anti-inflammatory medications, antibiotics, and lubricating drops. Common abbreviations used in ocular prescriptions are defined. Proper administration techniques for eye drops, ointments, and injections are outlined. Potential complications of certain medications are also noted.
This document discusses antihistamines, which are drugs that competitively block the actions of histamine at H1 receptors. It describes the pharmacological actions and effects of first-generation antihistamines, which provide relief from allergy symptoms but often cause sedation as a side effect. Second-generation antihistamines are introduced that have higher H1 selectivity and do not cause sedation. Specific second-generation antihistamines are outlined, including fexofenadine, loratadine, desloratadine, cetirizine, and levocetirizine. Their indications, pharmacokinetics, and advantages over first-generation antihistamines are summarized. The
This document provides summaries of several drug safety issues discussed in the June 2014 issue of Prescriber Update, including:
1) Atomoxetine can cause suicidal ideation and behavior in some patients. Patients taking atomoxetine should be closely monitored for new or worsening depression, agitation or irritability.
2) Zopiclone can cause impairment the day after use that can last over 11 hours, affecting driving ability. Patients should be warned about this risk and zopiclone should only be used short-term.
3) Olanzapine depot injections carry a small risk of post-injection syndrome within 1 hour of injection, requiring monitoring for 2 hours after doses. Symptoms usually resolve within
T abuhadid opioid_abuse_and_withdrawalLaurie Crane
Opioid Abuse and Withdrawal discusses opioid abuse, withdrawal symptoms, medications used for withdrawal like buprenorphine and methadone, and assessing withdrawal severity using the Clinical Opioid Withdrawal Scale (COWS). It explains that short-acting opioids cause withdrawal sooner than long-acting ones. Precipitated withdrawal can occur if withdrawal medications are given before full withdrawal occurs. The document provides a case study to demonstrate accurately using the COWS scale to rate withdrawal severity.
The document discusses poisoning, including what causes poisoning, common symptoms of poisoning, and treatment for poisoning. It states that medications are the most common cause of poisoning, with paracetamol, aspirin, calcium channel blockers, opioids, and tricyclic antidepressants most commonly linked to poisoning. Household products and contaminated food can also sometimes cause poisoning. Young children are at high risk of poisoning because they put things in their mouth without knowing if they are harmful. Symptoms vary but can include nausea, vomiting, drowsiness, and changes in breathing and heart rate. Treatment involves calling for help, checking airways, giving activated charcoal or antidotes, and monitoring in the hospital through blood tests and ECG
The document discusses drugs used to treat allergic rhinitis, cough, and colds. It describes the mechanisms and uses of various classes of drugs including oral and intranasal antihistamines, intranasal glucocorticoids, intranasal cromolyn sodium, decongestants, antitussives, expectorants and mucolytics. It notes risks of rebound congestion from overuse of decongestants and recommends limiting use to 3-5 days to prevent dependency.
This drug combination contains loperamide hydrochloride, which is used to treat diarrhea. Loperamide works by slowing intestinal movement and fluid secretion to allow more time for water absorption. It is well absorbed from the gastrointestinal tract and has a half-life of around 10-14 hours. Common side effects can include abdominal pain, nausea, and vomiting. Loperamide should be used with caution in patients with liver or kidney disease and is not recommended for children under 2 years old.
One Step Clinic is a leading outpatient addiction treatment facility in Ireland. For suitable patients Naltrexone implants are administered as part of a sustained treatment option.
Ibugesic Plus (Generic Ibuprofen and Paracetamol Tablets) The Swiss Pharmacy
Ibugesic Plus contains 2 ingredients: Ibuprofen And Acetaminophen (Paracetamol). This medicine is used for the management of mild to moderate pain and inflammation in conditions such as dysmenorrhoea, headache, including migraine, post-operative pain, dental pain, musculoskeletal and joint disorders, peri-articular disorders and soft tissue disorders (sprains and strains).This combination product works by blocking your body's production of certain natural substances that cause inflammation. This effect helps to decrease swelling, pain, or fever.
This document provides training for EMTs and EMRs on administering naloxone to patients experiencing an opioid overdose. It aims to reduce overdose mortality and morbidity by instructing first responders. The training covers recognizing overdose symptoms, indications and contraindications for naloxone use, possible adverse reactions, proper administration techniques via intranasal spray or intramuscular injection, and the importance of transporting patients for additional care and monitoring after naloxone administration. Responders must be prepared to manage agitated patients and the potential for return of overdose symptoms due to naloxone's shorter duration than opioids.
This document provides an overview and training for a program to train pharmacists in Maryland on responding to opioid overdoses. It begins with introducing the program and providing statistics on the opioid epidemic in Maryland. It then defines harm reduction and discusses recognizing and responding to overdoses, including administering naloxone. The document provides details on naloxone administration and storage/disposal, as well as information for pharmacists on dispensing naloxone. The goal is to equip pharmacists with knowledge to help prevent overdose deaths in their communities.
This document provides training for EMTs and EMRs on administering the opioid antagonist naloxone. It aims to reduce deaths from opioid overdose by instructing first responders. The training covers recognizing and treating opioid overdose, indications and contraindications for naloxone use, possible adverse reactions, and how to prepare and administer naloxone via intramuscular autoinjector or intranasal spray. Responders learn to identify overdose, administer naloxone, manage adverse reactions, and ensure transportation to definitive care.
Naloxone, also known as Narcan, is a medication used to reverse opioid overdoses. It works by blocking opioid receptors in the brain and reversing the life-threatening effects of overdoses from drugs like heroin, morphine, and oxycodone. Signs of an opioid overdose include little or no breathing, blue/grey skin color, and lack of response. If an overdose is suspected, it is important to call 911, administer naloxone, and provide rescue breathing until emergency help arrives. Naloxone is safe and effective for reversing overdoses, but its effects only last 30-90 minutes so continued monitoring is needed.
This document summarizes the management of opioid analgesic overdoses. It notes that opioid overdoses can affect multiple organ systems and disrupt normal pharmacokinetics, prolonging intoxication. It also discusses the increasing rates of opioid prescriptions and overdoses in the US. The classic signs of opioid overdose are described as well as diagnostic considerations. Management involves supporting respiration with a bag-valve mask and administering naloxone to reverse effects. Doses of naloxone are outlined and it is noted that patients may need to be observed for extended periods, especially if long-acting opioids were used, to monitor for recurrent respiratory depression. Potential pitfalls in management are also summarized.
This document provides education and training on opioid overdoses and the use of naloxone for Ohio EMS personnel. It describes the development and uses of naloxone as an opioid antagonist for emergent overdose treatment. It outlines the types of opioids commonly involved in overdoses and their routes of administration. The document then details the signs and symptoms of opioid overdose as well as associated medical complications. It provides information on the mechanisms of naloxone and potential adverse effects upon administration. The document concludes by outlining Ohio EMS protocols for the administration of intranasal naloxone by emergency medical responders and emergency medical technicians under medical director approval and training.
This document provides education and training on opioid overdoses and the use of naloxone for Ohio EMS. It discusses the development and increased demand for naloxone, common opioids and their effects. It outlines administration routes for naloxone and the expansion of Ohio EMS scope of practice to allow EMTs and EMRs to administer intranasal naloxone with medical director approval and training. Potential adverse effects of naloxone administration are also reviewed.
Management of Opioid Analgesic OverdoseSun Yai-Cheng
This document summarizes the management of opioid analgesic overdoses. It notes that opioid overdoses can have life-threatening effects on multiple organ systems. The duration of action varies between opioid formulations and an overdose can prolong intoxication. Prescriptions for opioid analgesics in the US increased 700% from 1997-2007. Opioid overdoses lead to over 27,500 health care facility admissions in 2010. Clinical signs of overdose include respiratory depression, apnea, miosis, and stupor. Naloxone is the antidote and works by reversing opioid receptor activity but has a shorter duration than many opioids. Higher and repeated naloxone doses may be needed for long-acting opioids like
This document discusses overdose prevention and harm reduction strategies. It defines overdose as occurring when a toxic amount of drugs overwhelms the body. It then focuses on opioid overdose, describing signs and symptoms, priority groups at risk, and how to respond by stimulating the person, calling for help, ventilating if needed, administering naloxone, and monitoring the person. It also discusses access to naloxone in Texas, stimulant overdose, and general risk factors. The document promotes harm reduction strategies like avoiding mixing drugs, using less after periods of no use, knowing one's tolerance, and not using alone.
The document discusses opiate intoxication and treatment. It covers the history, physical exam findings, differential diagnosis, management, and complications of opiate overdose. Key signs of overdose include depressed consciousness, respiratory depression, miosis, and fresh needle marks. Treatment involves supportive care, naloxone to reverse effects, activated charcoal if ingestion was recent, and monitoring for complications like withdrawal symptoms, infections from needle use, or acute lung injury.
Conscious sedation is a technique used to relax patients for dental procedures while keeping them awake. The most common method is nitrous oxide delivered via nasal hood. Characteristics of conscious sedation include the patient remaining awake but impaired. Children are more easily sedated than adults. Risks include unintended loss of consciousness. Evaluation of patients includes medical history, physical exam, and determining ASA class. Preparations include instructions, fasting, and having a responsible adult. Techniques include inhalation of nitrous oxide, intravenous drugs, and oral drugs. Proper equipment and monitoring of sedation levels is important. Post-sedation instructions warn against driving or operating machinery for 18 hours.
Phenol - Hazardous Substance Fact Sheet - Resources for Healthy Children www.scribd.com/doc/254613619 - For more information, Please see Organic Edible Schoolyards & Gardening with Children www.scribd.com/doc/254613963 - Gardening with Volcanic Rock Dust www.scribd.com/doc/254613846 - Double Food Production from your School Garden with Organic Tech www.scribd.com/doc/254613765 - Free School Gardening Art Posters www.scribd.com/doc/254613694 - Increase Food Production with Companion Planting in your School Garden www.scribd.com/doc/254609890 - Healthy Foods Dramatically Improves Student Academic Success www.scribd.com/doc/254613619 - City Chickens for your Organic School Garden www.scribd.com/doc/254613553 - Huerto Ecológico, Tecnologías Sostenibles, Agricultura Organica www.scribd.com/doc/254613494 - Simple Square Foot Gardening for Schools - Teacher Guide www.scribd.com/doc/254613410 - Free Organic Gardening Publications www.scribd.com/doc/254609890 ~ NJ Health
DOPE pilot project, 2016, on the IU-Bloomington campus that involves this 45-minute workshop, and the ability to pick up naloxone at the IU Health Center. Sponsored by OASIS, https://studentaffairs.indiana.edu/oasis/, supoported by the IU Health Center and Indiana's Overdose Lifeline, Inc.
Naloxone is an opioid antagonist used to reverse opioid overdoses. It works by binding to opioid receptors in the brain more strongly than opioids, kicking the opioids off the receptors and restoring breathing. Naloxone can be administered intravenously, intramuscularly, subcutaneously, or intranasally. It takes effect within 2-5 minutes and lasts 30-90 minutes. Signs of opioid overdose include unconsciousness, blue lips/fingertips, slow/shallow breathing, and pinpoint pupils. Naloxone administration follows the SAVE ME steps of stimulating, providing airway/ventilation, evaluating, injecting naloxone into muscle, and re-evaluating
What you need to know about naloxone (final)Mike Wilhelm
This document provides information about naloxone and opioid overdoses. It discusses the scope of the opioid overdose problem, risk factors for overdose, signs of overdose, how naloxone works to reverse an overdose, and different naloxone formulations including injectable, auto-injector, and intranasal options. Instructions are provided for administering the various naloxone products. The document aims to help understand overdoses and the role of naloxone in preventing overdose deaths.
#IOM - Prenoxad Presentation and TrainingKevin Jaffray
Prenoxad training package delivered to Mental Health team at Nobles hospital, and all satellite services on the Island, also delivered as part of a health week in Jurby Prison. A program in the prison started the next day.
This document discusses strategies to address the opioid overdose epidemic, including increasing access to the opioid overdose reversal drug naloxone. It summarizes models of overdose prevention programs that distribute naloxone, studies showing these programs are associated with reductions in overdose deaths, and the cost-effectiveness of naloxone distribution. The document then reviews New York state's law allowing community distribution of naloxone and a pilot program that trained EMTs, law enforcement officers, and other first responders to administer naloxone, resulting in over 200 overdose reversals.
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This document provides information about bailout kits and training being conducted by the Lynnfield Fire Department. It includes details about the components of the bailout kits being issued, which were obtained through a grant from the Lt. Joseph P. DiBernardo Memorial Foundation. The training will consist of an initial lecture and demonstration on a low height prop to emphasize safe deployment, with additional opportunities for practice. Bailout kits will be issued after final training, with annual refresher training planned to maintain proficiency. The goal is to properly train all firefighters to safely use this equipment.
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2. Objectives
• By the end of this course the participants will
learn about intranasal naloxone and will be
able to:
• Recognize the signs and symptoms of an
overdose
• Identify how to use intranasal Naloxone
• Identify the possible responses to intranasal
Naloxone
• Be able to prepare and administer intranasal
Naloxone
• Describe how continued support should be
provided to the overdose victim
3. When is intranasal Naloxone used?
Bystanders should have contacted EMS (Dial 911) or sent for
help
Bystanders may have provided respiratory support (rescue
breathing) to the limit of their skills, but reversal of the cause
of failed breathing is the real treatment.
Use of intranasal Naloxone is for when the person is not
responsive.
Intranasal Naloxone removes opiate effects and can reduce
the duration of low oxygen in the blood, preventing injury or
death.
Prolonged reduced breathing can result in injury to the brain.
While the person is not responsive, lung injury related to
having stomach contents get into the lungs can occur and this
can also cause death.
4. Opiates and Opioids
Chemicals that act in the brain to:
Decrease feeling of pain
Decrease the reaction to pain
Provide comfort
May be used for pain from injury or after
having procedures done (surgery) or as part of
long term care for cancer or other diseases
that are painful and are expected to not go
away
Both opiates and opioids are often misused
resulting in danger
5. Opioids versus Opiates
Opiates are concentrated from the opium
poppy plant and are not made, but purified
from the plant fluids, like maple sugar.
Opioids are manufactured and do not come
from plants.
Opiates and Opioids act the same in the brain
Examples of opiates Morphine, Codeine and
Heroin
6. Opioids & Opiates
After prolonged use of these substances
increasing amounts are needed for the same
effects.
Common side effects include:
Nausea and vomiting
Drowsiness
Itching
Dry mouth
Small pupils
Constipation, or difficulty having bowel
movements
8. Heroin
He ro in is an
o piate which
m ay be
inje cte d,
sno rte d
(inhale d), o r
sm o ke d. It has
m any stre e t
nam e s.
9. Naloxone is only used for opiate
overdose
Remember, the following common
street drugs are not opioids/opiates
and therefore not addressed by this
portion of the protocol: cocaine, LSD,
ecstasy(Molly), sedatives/tranquilizers,
and marijuana.
10. Opioid & Opiate Addiction and Treatment
Drugs
Methadone is an opioid which may be used as a pain
reliever, but is also commonly prescribed in addiction
treatment.
Suboxone and Subutex are brand names for the opioid
buprenorphine, which may be used as a pain reliever,
but is also commonly prescribed in addiction treatment.
These drugs last a long time and can help reduce the
craving for opiate and opioids for whole days.
Methadone and buprenorphine are never used alone as
the sole plan for treatment of addiction, but are used in
combination with counseling and skill learning efforts.
11. Who’s at High Risk for Overdose?
Individuals using medical visits and care from
multiple doctors who are not following
instructions about prescription use
Users of prescriptions that should belong to
others
Users who inject drugs for greater effects
Former users who are recently released from
prison or who entering and exiting from drug
treatment programs
12. Who else is at risk?
Elderly patients using opiates or opioids for
pain
Patients using pain relieving patches
incorrectly
Children who accidentally take pain-killers in
their homes or the homes of others
13. Intranasal Naloxone
Naloxone (Narcan) is an
antidote that can reverse
overdose of
opioids/opiates.
Naloxone is NOT
effective against
respiratory depression
due to non-opioid drugs
(or other causes).
14. Why Intranasal Naloxone?
Very low risk of
exposure to blood (no
needle)
Can be administered
quickly and with little
training
Onset of action is quick
Very effective when
used
15. Why Intranasal Naloxone?
Wo rks
q uickly
since the
no se has a
larg e are a
fo r
abso rbing
drug s
dire ctly into
the blo o d
stre am .
16. Why an is it used with an Atomizer?
Sq uirting the
liq uid drug as a
fine m ist
co ve ring m o re
o f the surface ,
like spray paint
o r hair spray
incre ase s e ntry
into the
blo o dstre am .
17. What does Opioid/Opiate overdose look like?
The person is:
Not responsive when shaken
Possibly not breathing well, or not
breathing at all
Possibly breathing less than 6 breaths
per minute
Possibly having a bluish color of the
skin, nails or lips
Small pupils
18. When to use intranasal Naloxone?
If a person is not responding to you.
If bystanders report drug use and the person
is not responding to you.
If there are drug bottles, or signs of injection of
drugs on the skin (“track marks”) and the
person is not responding to you.
Call 911 to activate Emergency Services
Even if illegal activity was going on, the call
protects from criminal charges
19. The law protects whoever calls for emergency
help…
but, only If they call for help. GETHELPDIAL911
A person who has received an opioid antagonist is free from civil or criminal liability for
administering it to a person who he or she believes is experiencing an opioid-related
overdose so long as the person does not act acting recklessly, with gross negligence or
intentional misconduct. If medical assistance has not yet been sought, a person shall call
emergency services after administering an opioid antagonist.
20. Adult Nasal Atomizer Use
Administer Naloxone 2.0mg Nasal via atomizer (half in
each side of the nose)
If you know how, you may continue supporting the
breathing of the person
Consider contacting poison control if other poisons are
suspected : (800) 222-1222
27. Administration
Do rescue breathing via BVM
Look to see if the nose cavity is free of
blood or mucous
Assemble kit
Gently, but firmly, place the atomizer in
one side of the nose and spray half the
medication
Repeat on the other side
If only one side of the nose is available,
put all of the medication on that side
31. Adverse Reactions
When used, intranasal Naloxone can cause:
Runny nose
Sweating
Fast heart rate
Shakes
High blood pressure, or
Low blood pressure
Fear of causing withdrawal should not prevent
use when the person is unresponsive
32. Children can also overdose:
When an opioid overdose is suspected in a
child :
Same administration per StateWide Treatment
Protocols
33. Children
Remember, children have smaller noses and
some of the drug may run out of the nose and
down the back of the throat. This will not do
any harm.
34. Skills Practice
Given a scenario:
Prepare a intranasal Naloxone atomizer
using the required equipment
Demonstrate administration of intranasal
Naloxone on an adult intubation head
Demonstrate as well as explain how you
would provide continued support
Always request Emergency Medical
Services, dial 911, If not already
activated.
36. Course Summary
What we learned:
Why intranasal Naloxone is available as
an option for bystanders who witness
overdose
What an opioid overdose looks like
The reasons that justify use of intranasal
Naloxone
Legal protections if you dial 911
How to prepare an intranasal Atomizer
How and when to use the intranasal
38. References
Centers for Disease Control
Drugs.com
Federal Drug Administration
MDPH Bureau of Substance Abuse Services
N.O.M.A.D. (Not One More Anonymous Death
Overdose Prevention Project)
MA OEMS Statewide Protocols
Vermont Department of Health - EMS
Editor's Notes
Welcome!
This presentation is going to discuss the BLS use of Intranasal naloxone. Naloxone is the generic name while Narcan is the trade name.
Definitive treatment for an opioid or opiate overdose is the reversal of hypoventilation. In the past, EMTs have only provided respiratory support, but now we are adding the use of intranasal naloxone as a possible treatment option within the Vermont Statewide EMS Protocols.
So, what is an opioid? An opioid is a synthetic or semi-synthetic alkaloid that acts on the central nervous system to decrease perception of and reaction to pain. They are also used to increase pain tolerance. They are prescribed for acute, debilitating, chronic pain, or palliative care.
Opiates are morphine, codeine, and heroin and all are derived from opium poppies.
Long term usage of opioids and opiates is known for creating tolerance and/or addiction that requires increasing doses to maintain the same effect. There are many common side effects, but miosis is one that you should be using during your differential diagnosis.
As you can see, there are many brand and generic names for opioids and opiates.
Heroin is an illegal opiate. Street names for heroin include: Big H, Boy, Capital H, China White, Diesel, Dope, Horse, Junk, Smack and White Junk. There new and evolving names, and this is just a sampling.
Remember, Narcan is specific to opioid and opiate overdoses!
There are two opioid/opiate addiction treatment drugs: methadone and suboxone.
Who is at a high risk for an opioid or opiate overdose? As you can see by the list, there are many risk groups.
In addition the elderly, children, and people using pain relieving patches are also at risk for an opioid or opiate overdose.
Naloxone can reverse central nervous system and respiratory depression due to an overdose of opioids opiates. It is not effective against respiratory depression due to non-opioid drugs. Thus, it is important to recognize the signs and symptoms of an opioid or opiate overdose and use naloxone appropriately.
There are many positive reasons for bystanders to administer intranasal naloxone. It minimizes the risk for blood borne pathogen exposure. It can be rapidly administered and naloxone has a 3-5 minute onset with peak effect in 12-20 minutes.
Intranasal administration allows bystanders to administer naloxone almost as quickly as the intravenous route. The nasal mucosa is highly vascularized and absorbs drugs directly into the blood stream.
Briskly compressing the syringe converts the liquid naloxone into a fine atomized mist. This results in broader mucosal coverage and better chance of absorption into the blood stream than drops that can run straight back into the throat.
A toxidrome is a group of signs and symptoms constituting the basis for a diagnosis of a poisoning. Remember, there are many signs and symptoms of an opioid or opiate overdose, but intranasal naloxone is indicated for a patient with respiratory arrest or hypoventilation.
What are the indications of an opioid or opiate overdose? 1. Respiratory arrest or hypoventilation with evidence of use by bystander report, drug paraphernalia, prescription bottles, or track marks – and/or 2. recognition of the opiate/opioid toxidrome.
From Act 75: A person who has received an opioid antagonist is free from civil or criminal liability for administering it to a person who he or she believes is experiencing an opioid-related overdose so long as the person does not act acting recklessly, with gross negligence or intentional misconduct. If medical assistance has not yet been sought, a person shall call emergency services after* administering an opioid antagonist. *(or before)
For an adult, the dose is 2mg of naloxone. For intranasal administration, this is 1mg of Naloxone per nostril. Remember, the onset for naloxone is 3-5 minutes, so you may need to continue ventilating the patient. Also, consider contacting poison control or local medical control if poly-substance use is suspected.
The effects of naloxone may not last as long as the effects of the opioid or opiate; be prepared for a return of overdose signs and symptoms! If respiratory depression and altered mental status reoccur, you may need to repeat the dose of naloxone, so be in contact with your Medical Control.
For equipment, you will need one luer-jet needle free syringe, one vial of naloxone, and one atomizer.
Remove the caps from both ends of the luer-jet needle free syringe.
Remove the red cap from the naloxone vial. Screw the now open end of the vial into the syringe. It will become difficult to turn when it is threaded enough.
Attach the nasal atomizer to the opposite end.
This is what your final product should look like!
The administration will take some choreographing of your team members. Continue to ventilate your patient, assess the nares and suction as needed. Control your patient’s head and place the atomizer in one nare while carefully occluding the opposite nostril.
Aim slightly upwards and toward the ear on the same side of the nostril. Briskly compress the syringe to administer up to 1mg of atomized spray. Repeat in the other nostril. Remember that using both nostrils doubles the surface area available for absorption. Continue ventilating your patient with a bag valve mask.
Rapid opioid or opiate withdrawal may also cause the above signs and symptoms. This is more common in the chronic opioid or opiate user who has been administered naloxone. Nevertheless, if a patient is in respiratory arrest secondary to an opioid or opiate overdose, the administration of naloxone is a life-saving time-critical action.
Pediatric patients are less likely to be suffering from an intentional overdose, but children can still be victims of an opioid or opiate overdose, usually inadvertently from ingestion of non-secured medications. Treatment doses for pediatric patients are as follows:
Infant: 0.5mg per nostril (total 1mg)
Child: 1mg per nostril (total 2mg)
Remember to suction the child’s nose prior to the administration of naloxone.
You will need to practice drawing up the correct dosage and administering intranasal naloxone. Your practice of the 6 drug rights and of intranasal narcan administration will occur at your squad.
This is both a new drug and drug administration route for EMTs. You should be competent in the 6 drug rights and the intranasal skill set, which will take on-going training and practice.
Thank you to Central Massachusetts EMS Corporation and everyone else that helped develop this presentation. If you have questions, please contact Michael Leyden, Deputy Director for Vermont EMS.