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Naloxone Naloxone is a synthetic opioid antagonist that competes for the μ-opioid receptors that reverse the effects of opioids (Stahl, 2021, 560). Naloxone has “a high affinity for the mu-opioid receptor,” which makes naloxone an effective treatment for opioid overdose (Jordan & Morrisonponce, 2023). However, naloxone may precipitate withdrawal, causing complications for the patient (Stahl, 2021, 560). Results should occur within minutes (Singh & Saadabadi, 2023). However, if naloxone administration is unsuccessful after 10 mg, it must be assumed the patient has ingested other substances, or there is some other medical indication (Jordan & Morrisonponce, 2023). In past times, naloxone was typically given in a medical setting so the patient could be monitored and provided with medical intervention should complications arise. Naloxone can be given via intraosseus, intravenous, intranasal, IM, or SQ (Jordan & Morrisonponce, 2023). Due to the increasing opioid addiction epidemic and rates of overdoses, individuals can go home with naloxone, as well as purchase naloxone over-the-counter (Jordan & Morrisonponce, 2023). In addition, ambulance workers, police, and other healthcare workers may access naloxone over the counter to provide treatment for individuals who overdose (Jordan & Morrisonponce, 2023). The half-life of naloxone is 30-80 minutes, depending upon the individual (Jordan & Morrisonponce, 2023). The individual who receives naloxone should seek emergency care to be monitored for up to twelve hours (Jordan & Morrisonponce, 2023). However, if a patient requires a higher dose of IV naloxone, they should be admitted for further management (Jordan & Morrisonponce, 2023). Naltrexone Naltrexone is a μ-opioid receptor antagonist and is an effective alcohol and opioid addiction treatment (Singh & Saadabadi, 2023). Naltrexone works by preventing opioid intoxication and alters psychological dependence (Singh & Saadabadi, 2023). “This medication is a mu-opioid receptor antagonist and also a weaker antagonist of the kappa and delta-opioid receptors” (Singh, D & Saadabadi, 2023). Naltrexone aids in curbing ethanol consumption by altering the hypothalamic-pituitary-adrenal axis (Singh & Saadabadi, 2023). Naltrexone can be given by either the oral or monthly IM injection route (Singh & Saadabadi, 2023. The half-life of oral naltrexone is four hours after excreted from the kidneys (Singh & Saadabadi, 2023). The half-life of IM naltrexone is five to ten days (Singh & Saadabadi, 2023). The patient should be detoxed before initiation of naltrexone (Singh & Saadabadi, 2023). To assess potential withdrawal, the patient should receive an initial low oral dose of naltrexone, whether oral or IV, while monitored (Singh & Saadabadi, 2023). An additional dose can be given while continuing to watch for withdrawal symptoms. If the patient tolerates the medication, the dosage can be increased over time to an optimal dose (Singh & Saadabadi, 2023). If the patient chooses over time or cannot comply with the oral form, they can be started on the injectable form (Singh & Saadabadi, 2023). In the hopes of effective and timely treatment, naltrexone should be initiated in the hospital setting (Kirchoff et al., 2021). The patient should be seen in the outpatient setting for follow-ups to ensure efficacy, toleration, and treatment compliance. Healthcare professionals/workers with experience in psychiatry and substance use disorders are the most appropriate providers to prescribe naltrexone (Singh & Saadabadi, 2023). The patient can be switched to the injectable form of naltrexone in the outpatient setting. Buprenorphine/Naloxone Buprenorphine is a μ-opioid partial agonist, which can help with opioid withdrawal symptoms (Stahl, 2021, 560) and opioid cravings, approved for the treatment of opioid addiction (Kumar et al., 2023). “This drug is a synthetic analog of thebaine—an alkaloid compound derived from the poppy flower
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HEALTH SCIENCE
NURSING

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