question: What do they do with the patient after administering narcan?
comment: It is not possible to cure most overdoses, including opioid overdoses. The best thing you can do is to manage the symptoms until the body have broken down the substances enough to reach safe levels. With opioid overdose you can give multiple narcan doses. The issue is that narcan is broken down in the body much faster then opium and its effects therefore lasts much shorter. If you give a patient narcan they will be cured of the effects of the overdose but the opium is still in their body and the narcan will soon wear off and they need another dose. If narcan is unavailable you can also treat the other symptoms of the overdose. This will not prevent the effects of the drug but will delay death until the body have broken down the drug and the overdose is past.
passages: Section::::Administration.
  
  There are three ways to administer naloxone. The first method is intravenously, working within two minutes. The second is through the nose (intranasal), or it could be injected into the muscles (intramuscular). which works within 5 minutes. Most likely, more than one dose will be needed. The effects only last about half an hour. Naloxone is administered from home kits either by nasal spray or injection into the thigh.
  
  Section::::Effectiveness.
   In case of overdose or adverse reaction, the immediate intravenous administration of naloxone (Narcan) is a specific antidote. Oxygen, intravenous fluids, vasopressors and other supportive measures should be used as indicated.
  
  Section::::Pharmacology.
  
  Section::::Pharmacology.:Pharmacodynamics.
   The California Assembly passed an act to amend Section 1714.22 of the Civil Code, relating to drug overdose treatment in 2014. California Assembly Bill 1535 (2014) delegated the authority to all properly licensed California state pharmacists who had undergone a training program that consisted of no less than one hour of approved continuing education about the pharmacology of naloxone hydrochloride to dispense naloxone (under brand names including Narcan and Ezvio) under standards developed by the Medical Board of California in conjunction with the California Society of Addiction Medicine, the California Pharmacists Association, and any other appropriate entities. Although the bill does not require that naloxone be dispensed only to those at risk of needing it themselves directly rather than observing secondhand an emergency (suggesting family members of opiate addicts may be eligible, the bill does require with patient consent that the patient's primary care provider be notified with the consent of the patient only, and the legislative's counsel's digest suggests that under the bill trained pharmacists may dispense naloxone (presumably primarily as an off-label intanasal spray or Ezvio autoinjector unless the patient is trained to perform manual intramuscular injections in a way similar to how they currently dispense Plan B and other forms of oral birth control.)
   If minimal or no response is observed within 2–3 minutes, dosing may be repeated every 2 minutes until the maximum dose of 10 mg has been reached. If no response occurs at this time, alternative diagnosis and treatment should be pursued. The effects of naloxone may wear off before those of the opioids, and they may require repeat dosing at a later time. Patients experiencing effects should be monitored for respiratory rate, heart rate, blood pressure, temperature, ABGs and level of consciousness. Those with a greater risk for respiratory depression should be identified prior to administration and watched closely.
   Naloxone is commonly injected intravenously, which usually causes the drug to act within a minute, and lasts up to 45 minutes. It can also be administered via intramuscular, subcutaneous injection, or nasal spray. There is a prepackaged nasal spray that does not require assembly and delivers a consistent dose. It can be repeated if necessary. A generic version of the nasal spray was approved in the United States in 2019. A wedge device (nasal atomizer) attached to a syringe may also be used to create a mist that delivers the drug to the nasal mucosa. This is useful near facilities where many overdoses occur that already stock injectors.
   In April 2014, the US Food and Drug Administration (FDA) approved a hand-held automatic injector naloxone product that is pocket-sized and can be used in nonmedical settings such as in the home. It is designed for use by laypersons, including family members and caregivers of opioid users at-risk for an opioid emergency, such as an overdose. A nasal spray was developed in a partnership between LightLake Therapeutics and the National Institute on Drug Abuse. The approval process was fast-tracked.
   Naloxone has little to no effect if opioids are not present. In people with opioids in their system, it may cause increased sweating, nausea, restlessness, trembling, vomiting, flushing, and headache, and has in rare cases been associated with heart rhythm changes, seizures, and pulmonary edema.
   Naloxone is used intravenously in opiate addiction in emergency cases, in rapid opiate detoxification, and as a diagnostic tool. The nasal drug administration of naloxone was found to be as effective as the intravenous route. In opioid overdoses, where hypotension and sometimes damaged veins make intravenous administration difficult, nasal naloxone offers a wide margin of safety and reduced risk of infection from vessel puncture while enabling even untrained bystanders to assist a victim.
   DuPage County, the bulk of Cullerton’s district, has seen an increase in heroin use in the county. This was accompanied by an epidemic of overdoses and at one point the county was averaging one overdose death per week. In 2014, DuPage County began to train officers in the use of Narcan, a medication that reverses the effect of opioids like heroin in overdoses. Since the start of the program, twenty five overdose deaths have been prevented through the use of Narcan by first responders.
   Identical drugs can produce different results depending on the route of administration. For example, some drugs are not significantly absorbed into the bloodstream from the gastrointestinal tract and their action after enteral administration is therefore different from that after parenteral administration. This can be illustrated by the action of naloxone (Narcan), an antagonist of opiates such as morphine. Naloxone counteracts opiate action in the central nervous system when given intravenously and is therefore used in the treatment of opiate overdose. The same drug, when swallowed, acts exclusively on the bowels; it is here used to treat constipation under opiate pain therapy and does not affect the pain-reducing effect of the opiate.
   Patients that are specifically at risk of being impacted this way are those with alcoholic tendencies or malnourishment. 
  
  Section::::Naloxone.
  
  Naloxone effectively treats CNS and respiratory depression caused by opiate/opioid overdose.
  
  It allows adequate ventilation for impacted patients, and health professionals administer it intravenously. 
  
  In terms of hypersensitivity, the patient may subsequently suffer from restlessness, headache, and vomiting. 
  
  Opiates/opioids, such as heroin, can be contaminated with scopolamine, and if it is present, the patient may face an anticholinergic crisis. 
  
  Section::::Flumazenil.
   Naltrexone is sometimes used in the treatment of dissociative symptoms such as depersonalization and derealization. Some studies suggest it might help. Other small, preliminary studies have also shown benefit. Blockade of the KOR by naltrexone and naloxone is thought to be responsible for their effectiveness in ameliorating depersonalization and derealization. Since these drugs are less efficacious in blocking the KOR relative to the MOR, higher doses than typically used seem to be necessary.
  
  Section::::Research.:Low-dose.
   Following the use of the nasal spray device by police officers on Staten Island in New York, an additional 20,000 police officers will begin carrying naloxone in mid-2014. The state's Office of the Attorney General will provide US$1.2 million to supply nearly 20,000 kits. Police Commissioner William Bratton said: "Naloxone gives individuals a second chance to get help". Emergency Medical Service Providers (EMS) routinely administer naloxone, except where basic Emergency Medical Technicians are prohibited by policy or by state law.
   Naloxone
  
  Naloxone, sold under the brandname Narcan among others, is a medication used to block the effects of opioids, especially in overdose. Naloxone may be combined with an opioid (in the same pill) to decrease the risk of opioid misuse. When given intravenously, naloxone works within two minutes, and when injected into a muscle, it works within five minutes; it may also be sprayed into the nose. The effects of naloxone last about half an hour to an hour. Multiple doses may be required, as the duration of action of most opioids is greater than that of naloxone.
   In Canada, naloxone single-use syringe kits are distributed and available at various clinics and emergency rooms. Alberta Health Services is increasing the distribution points for naloxone kits at all emergency rooms, and various pharmacies and clinics province-wide. Also in Alberta, take-home naloxone kits are available and commonly distributed in most drug treatment or rehabilitation centres, as well as in pharmacies where pharmacists can distribute single-use take-home naloxone kits or prescribe the drug to addicts. All Edmonton Police Service and Calgary Police Service patrol cars carry an emergency single-use naloxone syringe kit. Some Royal Canadian Mounted Police patrol vehicles also carry the drug, occasionally in excess to help distribute naloxone among users and concerned family/friends. Nurses, paramedics, medical technicians, and emergency medical responders can also prescribe and distribute the drug.
   Like other drugs of this type, nalmefene may precipitate acute withdrawal symptoms in patients who are dependent on opioid drugs, or more rarely when used post-operatively, to counteract the effects of strong opioids used in surgery.
  
  Section::::Medical uses.
  
  Section::::Medical uses.:Opioid overdose.
  
  Intravenous doses of nalmefene have been shown effective at counteracting the respiratory depression produced by opioid overdose.
  
  This is not the usual application for this drug, for two reasons:
   Narcan is mostly used as a “rescue drug” for individuals suffering from opioid overdose. Narcan, related to morphine, is an opioid antagonist that was originally synthesized and patented by Mozes J. Lewenstein and Jack Fishman in the US in 1961. The drug was patented in the UK by the Japanese company Sankyo (now Daiichi Sankyo). The US FDA approved the drug in treatment of opioid overdose in 1971.
   Throughout the US, Narcan and naloxone have been made available OTC in 41 states; exceptions are Delaware, Hawaii, Kansas, Maine, Michigan, Nebraska, Oklahoma, South Dakota and Wyoming. The drug can be found in major retailers like CVS, Walgreens, Walmart and Kroger, as well as independent pharmacies. Many states offer lists of retailers where Narcan can be purchased. Narcan is covered by many health insurance plans.
  
  Section::::Company history.
  
  Section::::Company history.:Early history.
   After his tenure at DOV, Skolnick returned to the NIH in 2010, this time as the director of the National Institute on Drug Abuse's Division of Therapeutics and Medical Consequences (DTMC), which focuses largely on pharmacological therapies for addiction. Most notably, Skolnick's time at NIDA saw the FDA approval and deployment of the Narcan nasal spray tool, an easy-to-use opioid overdose reversal device developed in partnership with Lightlake Therapeutics. Narcan nasal spray is intended for distribution to the general public, allowing the friends or family of an overdose victim to counteract the drug's effects almost immediately, without waiting for emergency response personnel to arrive. Many lives are lost due to drug users' hesitance to contact emergency services, a trend which Narcan nasal spray may help combat.
   Common side effects of cinacalcet include stomach upset, vomiting, diarrhea, dizziness, nausea, weakness, and chest pain.
  
  Clinical trials conducted in the United States by Amgen to determine whether the drug is safe in children were halted by the FDA in February 2013 following the death of a 14-year-old patient.
  
  Section::::Overdose.
  
  Serious side effects, including overdose symptoms, of cinacalcet include:
  
  BULLET::::- burning
  
  BULLET::::- tingling
  
  BULLET::::- unusual feelings of the lips, tongue, fingers, or feet
  
  BULLET::::- muscle aches or cramps
  
  BULLET::::- sudden tightening of muscles in hands, feet, face, or throat
  
  BULLET::::- seizures
  
  Section::::Interactions.
   Narconon's "drug bomb" includes a niacin dose of 4000 mg/day. The risk to patients of taking high-dose niacin is one reason why medical experts assessing the Narconon program have found that it is a danger to patients; the Narconon program has been banned in a number of jurisdictions including France and Quebec.
   Naloxone is used for the emergency treatment of an overdose. It can be given by many routes (e.g., intramuscular, intravenous, subcutaneous, intranasal, and inhalation) and acts quickly by displacing opioids from opioid receptors and preventing activation of these receptors by opioids. Naloxone kits are recommended for laypersons who may witness an opioid overdose, for individuals with large prescriptions for opioids, those in substance use treatment programs, or who have been recently released from incarceration. Since this is a life-saving medication, many areas of the United States have implemented standing orders for law enforcement to carry and give naloxone as needed. In addition, naloxone could be used to challenge a person's opioid abstinence status prior to starting a medication such as naltrexone, which is used in the management of opioid addiction.
   While paramedics have carried naloxone for decades, law enforcement officers in many states throughout the country carry naloxone to reverse the effects of heroin overdoses when reaching the location prior to paramedics. As of July 12, 2015, law enforcement departments in 28 states are allowed to or required to carry naloxone to quickly respond to opioid overdoses.
  
  In Australia, as of February 1, 2016, naloxone is now available "over the counter" in pharmacies without a prescription. It comes in single-use filled syringe similar to law enforcement kits.
   There are two antidotes that are frequently used in the hospital setting and these are naloxone and flumazenil. Naloxone is an opioid antagonist and reverses the central nervous depressive effects seen in opioid overdose. In the setting of a colonoscopy, naloxone is rarely administered but when it is administered, its half-life is shorter than some common opioid agonists. Therefore, the patient may still exhibit central nervous system depression after the naloxone has been cleared. Naloxone is typically administered in short intervals with relatively small doses in order to prevent the occurrence of withdrawal, pain, and sympathetic nervous system activation. Flumazenil is a benzodiazepine antagonist and blocks the binding of benzodiazepines to gamma-aminobutyric acid receptors. Similarly to naloxone, flumazenil has a short half-life, and this needs to be taken into account because the patient may exhibit central nervous depression after the antidote has been cleared. Benzodiazepines are used in the treatment of seizures and subsequently, the administration of flumazenil may result in seizures. Therefore, slow administration of flumazenil is necessary to prevent the occurrence of a seizure. These agents are rarely used in the setting of a colonoscopy as 98.8% of colonoscopies use sedatives but only 0.8% of them result in the administration of one of these antidotes. Even if they are rarely used in colonoscopies they are important in preventing the patient from entering a coma or developing respiratory depression when sedatives are not properly dosed. Outside of the colonoscopy setting, these agents are used for other procedures and in the case of drug overdose.
   BULLET::::- In the episode of "House", "Skin Deep", opioid antagonist drugs were administered in order to completely remove the patient's heroin induced addiction/withdrawal symptoms (during an induced coma in order to relieve the extreme pain of their use), so that an accurate diagnosis of paraneoplastic syndrome caused by cancer was differentiated.
  
  BULLET::::- In an episode of "Royal Pains", a character dangerously tries to undergo a procedure (and go under anaesthesia) in his own home.
  
  BULLET::::- In an episode of Hannibal, Dr.Lecter administers Naloxone to Jack Crawford's wife after she tries to commit suicide by overdosing on morphine.
  
  Section::::External links.
  