ACEP Now

JULY 7, 2023

While naloxone can treat fentanyl overdose, overdose symptoms may persist when xylazine is involved. References Friedman J, et al. Alexander RS, et al. Love JS, et al. Reyes JC, et al. Ruiz-Colón K, et al. Capraro AJ, et al. Rodríguez N, et al. Malayala SV, et al. 2022;233:109380.

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ACEP Now

OCTOBER 15, 2023

After enrollment, patients were randomized either to a modified-release oxycodone-naloxone combination opiate, starting with an initial dose containing 5 mg of oxycodone, or placebo. The addition of naloxone to the tablets may also provide a confounder in terms of the analgesia provided. Jones CMP, Day RO, Koes BW, et al.

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ACEP Now

JULY 7, 2023

Patients with opiate overdose get naloxone. References American College of Emergency Physicians Clinical Policies Subcommittee on the Adult Psychiatric P, Nazarian DJ, Broder JS, et al. Currier GW, Chou JC, Feifel D, et al. Zaman H, Sampson SJ, Beck AL, et al. Patients with sepsis get antibiotics. Ann Emerg Med.

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ALiEM

OCTOBER 30, 2024

Alternatively, one can cut the 2 mg Suboxone (buprenorphine + naloxone combination) strips into 4 pieces after waiting for a longer washout period (72-96 hours of abstinence from non-medical opioids) before starting the induction. Multimodal medication options for fentanyl-xylazine withdrawal management in London et al.

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Dr. Smith's ECG Blog

MAY 5, 2023

Krantz et al authored a State-of-the-Art Review on Cardiovascular Complications of Opioid Use ( JACC 77(2):205-223, 2021 ) — in which mechanisms from Opioid Overdose that detail arrhythmia production ( up to cardiac arrest ) are elucidated — thereby providing an explanation for the unusual arrhythmias in today's case.

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EMDocs

JUNE 27, 2024

mg q20-30 min per dose) PRN naloxone in case of respiratory depression Some patients have SCD crises pain plan for reference Antimicrobials 11 Ceftriaxone + azithromycin if penicillin allergy for both children and adults. Alkindi S, Al-Busaidi I, Al-Salami B, Raniga S, Pathare A, Ballas SK. C or 100.4 mg/kg, max 0.4

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Dr. Smith's ECG Blog

JULY 27, 2023

This 29 year old African American patient was found down, unconscious, not breathing and was given 2 mg of intranasal naloxone by a bystander. PEARL #3: The pathophysiologic mechanism for producing amphetamine-induced acute MI is unclear ( Bazmi et al — SQUMJ 17(10); e31-37, 2017 — and — Sinha et al — Case Rep Cardiol, 2016 ).

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Don't Forget the Bubbles

JULY 5, 2023

Naloxone (opioid antidote) should be available in ED in case of severe respiratory depression. Macharia AW et al. Sinkin JC, Wood BC, Sauerhammer TM, et al. Ware et al. In addition to opiates, continue to offer paracetamol and NSAIDS (unless contraindicated). Monitor vital signs for respiratory depression. 2014; 349–356.

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ACEP Now

DECEMBER 10, 2023

Though paramedics administered naloxone, he remained somnolent. You ultimately begin a slow naloxone infusion and admit him to the medical ICU. You question yourself for ordering IV potassium and starting a naloxone infusion, knowing you are causing discomfort for the patient who has known significant cancer-related pain.

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