Thursday, 1 January 2015

Prevention and Management of Opioid Overdose

Opioid poisoning:

Opioid is a alkaloid found as natural source in the Opium poppy plant, Papaver somniferum. The term opiate is often used to describe all drugs with opium or morphine-like pharmacological action, which are more properly classified under the broader term opioid. Semi-synthetic opioids such as hydromorphine, hydrocodone, oxycodone and oxymorphone while derived from opiates are not opiates themselves.


Side effects of opioid:

1. Dependence,
2. Addiction,
3. Psychologic effects,
4. Withdrawal effects.

Opioid Withdrawal effects:

Opiate withdrawal syndrome effects are associated with the abrupt cessation or reduction of prolonged opiate usage.

In medical facilitiessuch as hospitals and clinics, the threat of relapse is possible when Post-acute-withdrawal syndrome is under-emphasized to patients in transitional phases, especially with short-term buprenorphine, methadone or health facilities.

 Opiate Overdose:

It is known that 16,000 deaths involved opioid analgesics in 2012.
72% of all deaths from pharmaceutical overdose, 30% involved benzodiazepines.
Mortality involving opioid tripled from 1.4 per 10,000 to 5.1 with in 1999-2012.

Causes of opioid overdose:

1. Misuse of prescription opioid by patient or takes an illicit drug such as heroin.
2. Dispensing error where the dose is miscalculated by clinician
3. Patient does not follow prescription directions.
4. Combines opioid with alcohol or use along with other drugs.
5. Poly substance abuse.

Risk population:

1. Patients using opioid overdose.
2. Heroin users.
3. Patients having sleep apnea and
4. Obese patients.

Steps that follow to avoid overdose deaths:

1. Encourage providers, persons at high risk to learn how to prevent and manage opioid overdose.
2. Ensure access to treatment for individuals misusing/addicted to opioid disorders.
3. Encourage prescribers to use state prescription drug monitoring programs (PDMPs)
5. Ensure ready access ti Naloxone.

Information to opioid prescribers:

1. Prescribers can check their states PDMPs database to determine if a patient is filing the prescriptions provided and obtaining prescriptions for the same or similar drugs from multiple physicians.
2. Select an appropriate opioid medication
a. Severity of symptoms
b. Patient's reliability in taking medications.
c. Dependence-producing potetial of the medication.

proper patient counselling may result in correct usage of opioids.
Antidote for opioid poisoning is "NALOXONE"


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