Nebulized narcan?

[ambodriver]

Nebulized narcan.

Yes?

No?

Why or why not?

Effective or ineffective?

[JTpaintball70]

I've never seen Narcan used like that, but if you can give it IN, I don't see why neb wouldn't work. I'm curious about this now. Anyone use neb Narcan?

[HERBIE1]

Nebulized narcan.

Yes?

No?

Why or why not?

Effective or ineffective?

For someone who is essentially apneic or has agonal respirations, obviously it is pointless. To me, nebulized naloxone is a longer term tx that is used for someone who may be lethargic, and you want to gradually improve his level of consciousness.

[tniuqs]

The most optimal uptake via neb for most broncho dilators is ~ 10 to 15 % efficacy.

I have nebulized Morphine (bronchogenic carcinoma) but I have never heard of narcan neb.

Why one would deliver narcan this way is beyond me when one can deliver narcan IV/IM/SC/ET.

Maybe something I have never heard of ???

cheers

[Kiwiology]

We have IM, IN and IV naloxone however it seems that future change might see it removed in favour of good airway and circulatory support rather than directly reversing the opiate in the field

[Lone Star]

The most optimal uptake via neb for most broncho dilators is ~ 10 to 15 % efficacy.

I have nebulized Morphine (bronchogenic carcinoma) but I have never heard of narcan neb.

Why one would deliver narcan this way is beyond me when one can deliver narcan IV/IM/SC/ET.

Maybe something I have never heard of ???

cheers

Forgive my 'student ignorance' but I've got a question or two here...

You mention Narcan IV/IM/SC/ET. I'm pretty sure that means Intravenous/Intramuscular/Subcutaneous/Endotracheal. Am I right so far?

Next question: If you have to intubate the patient due to airway compromise, doesn't it sesem counter productive to be adding liquid meds to a system that already has problems?

Since drugs like Narcan, MS, and others don't naturally occur in regular atmosphere, wouldn't it be logical to conclude that the lungs would recognize these drugs as 'foreign substances' and try to encapsulate it in mucus in an attempt to get it out of the lungs? This could then add to the pulmonary edema, increasing airway compromise.

[tniuqs]

Forgive my 'student ignorance' but I've got a question or two here...

You mention Narcan IV/IM/SC/ET. I'm pretty sure that means Intravenous/Intramuscular/Subcutaneous/Endotracheal. Am I right so far?

Next question: If you have to intubate the patient due to airway compromise, doesn't it sesem counter productive to be adding liquid meds to a system that already has problems?

Since drugs like Narcan, MS, and others don't naturally occur in regular atmosphere, wouldn't it be logical to conclude that the lungs would recognize these drugs as 'foreign substances'

Split up .. 2 questions here.

and try to encapsulate it in mucus in an attempt to get it out of the lungs? This could then add to the pulmonary edema, increasing airway compromise.

cheers I hope that helps.

[P_Instructor]

I have nebulized Morphine (bronchogenic carcinoma) but I have never heard of narcan neb.

cheers

Could you send me your protocol on nebulized MS, even for the reason displayed?

[tniuqs]

Could you send me your protocol on nebulized MS, even for the reason displayed?

Sorry but no protocols for this in ICU or oncology besides not that many standing orders or protocols for RRTs in the ICU/ Floors as primaraly we work from the MDs written orders or verbal, then the RRT enters those in the orders, we are permitted to do this, MS as per neb would be stretching those limits big time.

That said" Orders can vary dependent on the most recent study that they, the Inensivist has just read and / or individual fellow / resident writing those orders.

I have not nebulized M/S in EMS field.

cheers

Edited September 27, 2010 by tniuqs

[Kiwiology]

... and since when were we intubating anybody anymore?