Lipase Case Summary

Nevertheless, several studies have shown that intranasal Naloxone absorbs in the same amount of time as intravenous Naloxone when the administrator accounts for the time Naloxone takes for an I.V. to be placed. Granted the absorption rate is slower for intranasal admission versus intravenous, the nasal route still has a valuable blood supply allowing Naloxone to be absorbed efficiently (Robison and Wermeling 2131). Intranasal administration is effective enough to reverse drug overdose. Intranasal administration can be repeated every three minutes and last for 180 minutes while intravenous Naloxone

According to Lowe (2017), “…across the United States, a woman presents every 3 minutes to an emergency department for opioid misuse or abuse” (p.657). With the significant increase in the misuse of opioids over the last thirty years in the US, it has become a serious public health concern. With the most dramatic rise in opioid use being of childbearing age women, it is a very important issue in maternal health care (Keough & Fantasia, 2017). It is imperative that nurses are informed and have efficient knowledge of the potential risks, effects, treatment, and prevention of opioid dependence during pregnancy.

Naloxone, better known by its brand name Narcan, is an opiate antagonist that has the ability to reverse opiate overdoses. Due to the opiate epidemic, Narcan is being distributed in communities where opiate abuse is prevalent, and individuals in these communities are now administering the drug. However, administering the drug to someone with a suspected opiate overdose can be dangerous whether they are a skilled professional or civilian: “Administering narcan can be a wild experience the first time you do it because it's one of very few drugs that works very very rapidly and causes a very dramatic effect in a very short period of time especially depending on the dose.There's been a bad habit of people in the past to give very large amounts of naloxone very quickly and that can cause a patient to go from completely unconscious barely breathing or sometimes not even breathing at all and then within in a matter of seconds they can be awake alert breathing, One of the side effects is extreme agitation so these patients can become extremely like I said agitated or sometimes even combative or violent. So now we are learning as providers it's better to give it in more measured doses give smaller amounts at a time to prevent that sort of effect from happening.” said Sean McMullen a paramedic with Gila River EMS (McMullen). Since individuals can become combative and

The opioid epidemic is considered a “great mistakes of modern medicine.” I feel that with the availability of counteractive drugs such a naloxone; the opioid abuse rate will increase. Knowing that there is a counteractive drug in the market, patients will fear less of opioid overdose and will promote opioid usage. Naloxone as a harm reduction approach to opioid use is an excellent choice for patients but comes with consequences.

It is important to not use drugs or alcohol while on naltrexone. Since the medication blocks the effects of substance abuse, it may be easier to overdose. Because of this, it is important to only take naltrexone that has been prescribed by a doctor.

The purpose of this study is to investigate the effects of sustained-release Naltrexone implants on opioid-dependent participants. The study will specifically focus on the frequency of opioids usage before and after treatment, the subjective “high” feeling of heroin while undergoing implant treatment, and consider the factors associated with opioid use/abuse. Naltrexone is a competitive opioid antagonist which blocks the action of heroin (and other opioids), therefore removing the “high” obtained from substance use. The goal of the Naltrexone is to gradually obviate the abuser’s desire to use heroin by removing this “high” feeling.

Initially opioids are prescribed to relieve pain, however many patients get hooked and addicted to opioids. The risks for addicted patients with chronic pain is yet known, in addition opioids are also more accessible, thus overdose cases have increased, some leading to death. A woman who is addicted to opioids during her pregnancy, has the possibility of leading her child to addiction and causing birth defects. Additionally, the addiction is expensive, thus to get the money it will lead to criminal activity or withdrawal symptoms such as pain, diarrhea, nausea, vomiting, and other symptoms. Needles, and various methods are used to inject opioids, however this will lead to transmission of diseases. Opioids cause damages emotionally, physically, and economically, as an attempt to make others aware of this ordeal, National Institute on Drug Abuse (NIDA) is communicating with teens through an online education program. Overconsumption is hard to ignore, however the prevention message are hard to disregard as

The use of opioids during pregnancy has increased drastically over recent years, causing newborns to fall victim to the opioid crisis. It has now become an epidemic, affecting people in the United States and globally making it a major health concern. A vast percentage leading to the opioid crisis is due to women in their childbearing stages of life. Newborns born to women addicted to opioids suffer through a form of newborn drug withdrawal known as Neonatal abstinence syndrome (NAS), resulting in increased admission rates, prolonged length of stay in the hospital and infants often require medication to recover. NAS is a result of opioid exposure in utero characterized by “central nervous system hyperirritability and autonomic nervous system dysfunction” (Kraft et

(n.d.) also conducted a study focused on infants that were exposed to buprenorphine or methadone while in utero. Unlike MacMullen et al. (2014) their focus was on predicting how the symptoms of NAS might manifest in the exposed newborns. Since the 1970s (MacMullen et al., 2014) methadone has been the treatment of choice for mothers with opioid dependence during pregnancy, the use of this drug allows for a decrease in withdrawal symptoms for the child after birth. The main categories of symptoms include central nervous system hyperirritability, gastrointestinal dysfunction, respiratory distress and vague autonomic symptoms (MacMullen et al., 2014). Although methadone has been being used for many years buprenorphine has only been used since 2002 in the United States (MacMullen et al., 2014). Their research was consistent with Kaltenbach et al. (n.d.) in that infants born to buprenorphine-exposed mothers had lower scores for NAS than those born to methadone-exposed mothers, but still had varying severities of symptoms and scores across all infants. For at least 10 days after birth, an expert scored the newborns on a modified Finnegan scale every 4 hours. The results showed that high birth weight was often a predictor for high NAS scores, along with lower NAS scores for infants delivered by cesarean section. MacMullen et al. (2014) were unable to find any connection between the use of methadone and buprenorphine to indicators of symptoms of NAS. The main

Opioid addicted babies need treatment in the hospital setting to help them through the withdrawal process. Studies are showing what medications to use to help reduce the length of hospital stay. Today, many neonates stay in the hospital much longer than years past, this is generally due to being born addicted to opioids. The United States is suffering from an epidemic of opioid abuse. When a pregnant mother is addicted to opioids these drugs cross the placenta, causing the neonates to be born addicted. According to Hall et al. (2015), this epidemic can cause opioid misuse, overdose or even death. When looking at the United States from 2005-2011, “more than 14% of pregnant women were dispensed an opioid at some time in their pregnancy”, (Hall, 2015, pg.40). Depending on the length of medication used and timing during the pregnancy will determine how a neonate will withdraw after birth. This withdrawal is becoming a common practice and is known as Neonatal Abstinence Syndrome (NAS). By 2015, this syndrome would affect one neonate in 200 births. Improvements in medications and techniques help neonates get through withdrawal. I have created a PICO to help form this paper. This paper will compare the two medications; Morphine and Buprenorphine are most commonly used to help neonates withdrawing in the

In the past 20 years, prescription opioid abuse has been a rapidly growing issue in the United States. This rapid increase in abuse has led to more overdose deaths, and the increase of individuals pursuing treatment for their addiction (Brady, McCauley, & Back, 2013). The rising frequency of maternal opioid abuse affects thousands of mothers and newborns each year. According to the National Institute on Drug abuse, the use of opiates during pregnancy can result in a drug withdrawal syndrome in newborns called neonatal abstinence syndrome (NAS). Almost every drug passes from the mother's bloodstream through the placenta to the fetus. Illicit substances that cause drug dependence and addiction in the mother also cause the fetus

Naltrexone is an FDA-approved non-opioid medication to prevent relapse after opioids have been completely eliminated from the body. Unlike, methadone and buprenorphine, it has no addiction potential.

This is 35 year old WM. Patient was seen at UAB ED for UTI and kidney stone on 3/30/2016. Patient was discharged with roboxin and ibuprofen. Patient has a history of Hep C, was told about 12 years ago, and was retested at UAB and HVC was positive. Patient is a current resident at the Villige. Patient has a history of substance abuse, denies current use, last use about 10 days ago. Patient is a current tobacco user, denies use of alcohol or illicit drugs. Patient reports some depressive moods, denies thoughts of suicide or

In response to the ever-growing opioid epidemic in the United States, many elected officials, health-centered agencies and addiction support groups have been advocating for friends and family members to arm themselves with naloxone, an opioid antagonist commonly known as Narcan. Narcan (naloxone) can be given by intramuscular (IM) injection - into the muscle of the arm, thigh or buttocks - or with a nasal spray device (into the nose).

Infant death may occur when infants were exposed to larger than usual amounts morphine in the human breast milk of mothers who are “rapid metabolizers” of codeine.