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Naloxone FL Standing OrderSafe Medication Disposal Sites

Tiffany Sherrill, Pharm.D

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Objectives

• Explain how overdose occurs and how naloxone reverses an overdose

• Highlight the FL Standing Order for dispensing Naloxone

• Discuss products available per standing order

• Share locations of Walgreens in Orange County that have safe medication disposal drop off

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Overdose

• Overdose is an acute condition that usually occurs over 1-3 hours

• May be caused by:

• Excess intake of opioids

• Combination of opioid and a CNS depressant

• Opioid use in someone with a compromised respiratory system or metabolic condition

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Mechanism of Overdose

Slow Breathing

Breathing Stops

Lack of oxygen may cause brain damage

Heart Stops

Seizure, stroke, or even death

Naloxone

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What is naloxone and how does it work?

• Naloxone is a mμ opioid receptor antagonist that works by reversing both the clinical and toxic effects of the overdose. It works by blocking the opioid’s action on the brain and restoring breathing.

• The only purpose is to reverse overdose; there is no abuse potential and this medication cannot produce a “high”

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FL Standing Order for Naloxone

• Effective 5/3/17 and will expire in 60 days, unless extended

• Allows all licensed pharmacies to dispense Naloxone to ANYONE WITHOUT a prescription

• Provides immunity from civil liability for anyone acting in good faith

• Requires the SAMHSA Opioid Overdose Prevention Toolkit 5 Essential Steps for First Responders be followed

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What can be dispensed per standing order

Last Updated January 2016

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Executive Order

• States that sufficient funds be made available for reimbursement for the Naloxone

• The process for reimbursement is still being established

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What does this look like?

• Any Person (friend/family member/first responder) comes into pharmacy and requests Naloxone

• Pharmacist enters just like a prescription (person requesting is the patient)

• Insurance may or may not cover (Direct billing in the works)

• Sold as a Rx with counseling and education sheet

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2 Ways to Administer Naloxone

• Nasal (intranasal – IN)

• Auto-Injector (intramuscular – IM)

This is the product that you will most

likely see used the most

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Administering Naloxone - Autoinjector

• Evzio is an opioid antagonist indicated for the emergency treatment of known or suspected opioid overdose, as manifested by respiratory and/or central nervous system depression

• Should be administered into the anterolateral aspect of the thigh, through clothing if necessary; may be given either IM or SC

• The autoinjector contains a speaker that provides instructions regarding where to administer and for how long. Each kit also contains a training device for practice.

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Naloxone Counseling

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SAMHSA Opioid Overdose Prevention Toolkit

5 Essential Steps for First Responders

Step 1: Recognizing an overdose

Step 2: Calling 9-1-1

Step 3: Rescue Breathing

Step 4: Administer naloxone

Step 5: Stay Until Help Arrives

Questions?

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SAFE MEDICATION DISPOSAL

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1920 ALOMA AVEWINTER PARK, FL 32792407-628-1899

408 E MICHIGAN STORLANDO, FL 32806407-843-0956

7650 W SAND LAKE RDORLANDO, FL 32819407-370-6742

12100 S APOPKA VINELAND RD

ORLANDO, FL 32836

407-238-0600

12279 LAKE UNDERHILL RD

ORLANDO, FL 32825

407-273-0817

ORANGE COUNTY WALGREENS DISPOSAL SITES

THANK YOU