Opioid Overdose Flashcards
Harm Reduction Perspcetive
focuses on reducing or preventing the harms, rather than abstinence.
harm reduction include policies, programs, and practices with the aim of reducing the harms associated with substances in persons unable or unwilling to stop use.
Opioids Characteristics
Opiates - natural substances (morphine, codeine) directly derived from opium poppy.
Opioids - include opiates in addition to many semisynthetic and synthetic agents used as analgesics.
Illicit Opioids - heroin and fentanyl (fentanyl use is steadily rising in Canada).
Opioid mechanisms
act on opiate receptors and neurotransmitter systems in the CNS.
cause CNS depression and have major effect on the brain reward system.
can be taken orally, IV, sniffed or smoked.
Primary effects of Opioids
euphoria, analgesia, drowsiness, slurred speech, decreased RR, gastrointestinal peristalsis, decreased pupil size.
Withdrawal of Substances
nurses must be alert to the possibility of withdrawal in any patient with a history of substance abuse.
alcohol and bento withdrawal can be life threatening.
withdrawal from opioids is not life threatening but can cause discomfort.
Signs of Opioid Overdose
pinpoint pupils
clammy skin
depressed respiration
decreased LOC (may lead to coma or death)
Nursing Management of Opioid Overdose
ABCs are top priority (check for airway obstructions, listen to breath sounds, pattern of breathing), check pulses (strength, rhythm, regularity), assess for cyanosis (cap refill, ECG rhythm)
Provide continuous vital sign monitoring.
Resuscitation measures if the patients condition deteriorates (CPR and defibrillation).
Patient with Decreased LOC
always check CBG - opioid overdose can cause hypoglycaemia.
patient may be transfused with a solution containing dextrose.
Naloxene (Narcan)
opioid antagonist - used to treat overdose/opioid induced respiratory depression.
onset - 1 minute, duration - 45 minutes.
intranasal route is more convient.
IM preferred site is vastus lateralis muscle.
Opioid Withdrawal
withdrawal can occur following admin of narcan.
symptoms include cravings, abdominal cramps, diarrhea, tremors, chills, overall body aches, sleep disturbances, anxiety, N/V.
Methadone
opioid to treat severe pain or opioid addiction.
special preoperative considerations to ensure no doses are missed.
avoid using other sedating substances such as alcohol and benzos.
Buprenorphine
long acting opioid drug used to replace the shorter acting opioids that someone may be addicted to such as heroin or fentanyl.
less sedating and lower risk of overdose than methadone.
available as sublingual tablets.
