NAPLEX Question of the Week: Antidotes
Antidotes are a lifesaving, key group of medications that every pharmacist should have knowledge including dosing, administration, and storage. Today's question focuses on the most common reversal agent given in clinical practice.
A 54 yo F with a PMH of diabetes, osteoarthritis, and hypertension presents to the ED from home after being found very unresponsive by husband who brought her in via private vehicle. Home medications include glipizide, metformin, Norco, and Zestoretic. Blood gas is significant for increased pCO2 with a respiratory rate of 5 per minute. The attending wishes to administer naloxone.
Naloxone is available in which of the following dosage forms for opioid reversal? Select all that apply.
D. Oral solution
E. Sublingual tablet
Answer and Rationale: B and C are the correct answers. The opioid epidemic has had a tremendous impact on morbidity and mortality within the world including the United States. Pharmacists are poised to provide naloxone to at risk patients as nearly every state allows for dispensing without a prescription. Therefore knowledge of naloxone is crucial in order to provide patients and their families with a medication that could save lives. This patient is on Norco which contains hydrocodone which most likely led to the patient's presentation. Naloxone is not commercially available as an inhalation solution making answer A incorrect. Naloxone is not available in an oral solution making D incorrect. Additionally, naloxone is available as a sublingual tablet with buprenorphine for opioid dependence but not as an acute reversal agent. Therefore answer E is incorrect.