User:Alexloopy/Opioid overdose
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Treatments[edit]
If someone is suspected to have overdosed on opioids, call for medical attention, administer naloxone, and provide basic life support as soon as possible.[1]
Naloxone[edit]
Naloxone works by temporarily blocking the effects of opioids, including respiratory depression and sedation.[1][2] Naloxone is available to the public in the United States in two routes of administration: intranasal and intramuscular/subcutaneous. Intranasal forms include Narcan, approved in 2015, and Kloxxado, approved in 2021. Formulations that are injectable into the intramuscular or subcutaneous spaces include Evzio, approved in 2014, and Zimhi, approved in 2021. The doses are approved for both children and adults and may be repeated every 2-3 minutes.[3][4][5] Synthetic opioids like fentanyl and carfentanil are much more potent than prescription opioids and heroin.[6] There is some debate about whether increased doses of naloxone are required to reverse overdose from synthetic opioids, however this concern has prompted FDA approval of higher dose naloxone formulations such as Kloxxado and Zimhi.[3][7] If a person suspected of overdose regains consciousness, medical attention is still necessary. Naloxone is temporary and people revived with the medication can stop breathing again.[1]
| Brand name | Route of Administration | Dose | Additional Considerations |
|---|---|---|---|
| Narcan[8] | Intranasal | 4mg | |
| Kloxxado[9] | Intranasal | 8mg | |
| Evzio[4] | Intramuscular/subcutaneous auto-injector | 2mg | |
| Zimhi[5] | Intramuscular/subcutaneous prefilled syringe | 5mg | For individuals 12 years of age or older |
Access to Naloxone[edit]
Opioid overdose should be reversed as soon as possible. To shorten the time between overdose and naloxone administration, multiple programs have been enacted to improve naloxone access for drug users, caregivers, and first responders.[10] These efforts include FDA approval of intranasal and injectable naloxone over the counter, professional organizations recommending physicians to co-prescribe naloxone when opioids are used for pain management, free community overdose education and naloxone distribution (OEND) programs, and efforts to train non-medical first responders such as firefighters and police to use naloxone. These actions have reduced opioid-related deaths at the state and national levels and are cost-effective.[10][11]
Basic Life Support[edit]
Opioid overdose leads to death when people stop breathing.[12] Bystanders trained in first aid can evaluate people who have overdosed and provide basic life support including rescue breathing via bag valve mask or mouth to mouth. If the person who has overdosed does not have a pulse, rescuers should begin CPR.[1]
Other Treatments[edit]
Another medication that can be used to treat opioid overdoses is Nalmefene, Which is an opioid derivative structurally similar to Naltrexone. It works similarly to Naloxone but has a longer half life.[13] It is approved for intravenous, intramuscular, and subcutaneous administration by prescription only, unlike the over the counter formulations of naloxone.[14]
References[edit]
- ^ a b c d "Responding to a suspected opioid overdose | NIOSH | CDC". www.cdc.gov. 2021-07-19. Retrieved 2022-11-04.
- ^ Boyer, Edward W. (July 2012). "Management of opioid analgesic overdose". The New England Journal of Medicine. 367 (2): 146–55. doi:10.1056/NEJMra1202561. PMC 3739053. PMID 22784117.
- ^ a b "Higher-Dose Naloxone Nasal Spray (Kloxxado) for Opioid Overdose". JAMA. 326 (18): 1853–1854. 2021-11-09. doi:10.1001/jama.2021.15948. ISSN 0098-7484.
- ^ a b "EVZIO® (naloxone hydrochloride injection) Auto-Injector for intramuscular or subcutaneous use" (PDF). FDA.gov. October 2016.
{{cite web}}: CS1 maint: url-status (link) - ^ a b "ZIMHI (naloxone hydrochloride injection) for intramuscular or subcutaneous use" (PDF). FDA.gov. October 2021.
{{cite web}}: CS1 maint: url-status (link) - ^ Armenian, Patil; Vo, Kathy T.; Barr-Walker, Jill; Lynch, Kara L. (15 May 2015). "Fentanyl, fentanyl analogs and novel synthetic opioids: A comprehensive review". Neuropharmacology. 134: 121–132. doi:10.1016/j.neuropharm.2017.10.016.
- ^ Moss, Ronald B.; Carlo, Dennis J. (2019-02-18). "Higher doses of naloxone are needed in the synthetic opioid era". Substance Abuse Treatment, Prevention, and Policy. 14 (1): 6. doi:10.1186/s13011-019-0195-4. ISSN 1747-597X. PMC 6379922. PMID 30777088.
{{cite journal}}: CS1 maint: PMC format (link) CS1 maint: unflagged free DOI (link) - ^ "NARCAN® (naloxone hydrochloride) nasal spray" (PDF). FDA.gov. November 2015.
{{cite web}}: CS1 maint: url-status (link) - ^ "KLOXXADO (naloxone hydrochloride) nasal spray" (PDF). FDA.gov. April 2021.
{{cite web}}: CS1 maint: url-status (link) - ^ a b "Expanding Access to Naloxone: A Review of Distribution Strategies". Penn LDI. 2019-05-29. Retrieved 2022-11-04.
- ^ Abuse, National Institute on Drug (2017-03-30). "Naloxone for Opioid Overdose: Life-Saving Science". National Institute on Drug Abuse. Retrieved 2022-11-04.
- ^ Boom, Merel; Niesters, Marieke; Sarton, Elise; Aarts, Leon; Smith, Terry W.; Dahan, Albert. "Non-Analgesic Effects of Opioids: Opioid-induced Respiratory Depression". Current Pharmaceutical Design. 18 (37): 5994–6004. doi:10.2174/138161212803582469.
- ^ Wang, D. S.; Sternbach, G.; Varon, J. (May 1998). "Nalmefene: a long-acting opioid antagonist. Clinical applications in emergency medicine". The Journal of Emergency Medicine. 16 (3): 471–475. doi:10.1016/s0736-4679(98)00019-5. ISSN 0736-4679. PMID 9610980.
- ^ "Revex (nalmefene hydrochloride injection)" (PDF). FDA.gov.
{{cite web}}: CS1 maint: url-status (link)