NALOXONE LEARNING ABOUT NALOXONE COULD SAVE A LIFE

NALOXONE LEARNING ABOUT NALOXONE COULD SAVE A LIFE

WHAT IT IS

WHAT IT IS NARCAN (naloxone HCl) Nasal Spray is the first and only FDA-approved nasal form of naloxone for the emergency treatment of a known or suspected opioid overdose. The spray counteracts life-threatening effects of opioid overdose. Since most accidental overdoses occur in a home setting, it was developed for first responders, as well as family, friends, and caregivers. Although the spray can have a tremendous impact on saving a life in the event of an opioid overdose, it is important to remember naloxone does not replace the need for medical attention. It is important to remember to call 911 immediately to continue medical care. The nasal spray is a prescription medicine used for the treatment of an opioid emergency such as an overdose or possible overdose of opioids (when there are signs of breathing problems, severe sleepiness or nonresponsiveness) The spray is safe and effective for anyone, even children, in a suspected opioid overdose.

HOW IT WORKS In opioid overdose emergencies, recognizing symptoms and taking prompt action is critical to potentially saving a life. If you suspect an opioid overdose, administer NARCAN Nasal Spray and get emergency medical assistance right away. Read the following steps for administering the nasal spray, then watch the video on our website after you complete the PowerPoint to view an example of Naloxone administration. When administering NARCAN Nasal Spray, always be sure to call 911 right away, even if the person wakes up. Keep the patient under surveillance or close watch. If breathing does not return to normal or if breathing difficulty resumes, after 2-3 minutes, give an additional dose of NARCAN Nasal Spray using a new device in the alternate nostril. See video Peel back the package to remove the device. Hold the device with your thumb on the bottom of the plunger and 2 fingers on the nozzle. Place and hold the tip of the nozzle in either nostril until your fingers touch the bottom of the patient s nose. Press the plunger firmly to release the dose into the patient s nose.

HOW DOES NARCAN NASAL SPRAY WORK? NARCAN Nasal Spray is administered in the nostril and does not require evidence of breathing through the nose during administration. When someone has overdosed of opioids, the opiates overwhelm certain areas in the brain and interrupt a key part of the body s impulse to breathe. Breathing slows dangerously or stops. Quickly rescuing this person is crucial because prolonged, severe breathing problems can lead to brain injury or death. Naloxone, the active ingredient in NARCAN Nasal Spray, competes with opioids to bind with the same receptors in the brain. Usually, it reverses the effects of opioid overdose in 2 to 3 minutes. This buys the opioid-poisoned person time for emergency medical help to arrive. If necessary, a bystander can give an additional dose of NARCAN Nasal Spray if the patient doesn t respond, doesn t respond enough or relapses into breathing problems while awaiting additional help.

HOW LONG DOES NARCAN NASAL SPRAY TAKE TO WORK? If the patient does not respond in 2 to 3 minutes or responds and then relapses into respiratory depression, additional doses of NARCAN Nasal Spray may be given every 2 to 3 minutes until emergency medical assistance arrives. Each device is a single dose. If an additional dose is needed, you must use another device. NARCAN Nasal Spray has been shown in studies to stay in the body for about 2 hours. A second dose of NARCAN Nasal Spray may be necessary. One dose of naloxone may not be enough to reverse the effects of an opioid overdose that involves strong opioids or more. Or, sometimes, the naloxone dose can wear off before the opioids necessitating another dose. Emergency medical services (EMS) will have been called immediately and will hopefully arrive before a second dose is needed. But if help hasn t arrived, bystanders can administer additional doses of NARCAN Nasal Spray every 2 to 3 minutes in alternating nostrils if the patient doesn t respond, responds insufficiently or relapses back into respiratory depression.

WHO AT RISK Anyone exposed to prescription or illegal opioids should be aware of risk factors that may lead to an accidental, lifethreatening or deadly opioid overdose. People at higher risk of an opioid overdose include: anyone who takes prescription opioids (such as Percocet or OxyContin ), especially those taking higher doses, or taking them in combination with other substances such as alcohol or sleep medications known as benzodiazepines (which include Ativan, Xanax, and Valium). Additionally, risk is increased for those with medical conditions such as depression or lung/liver disease and anyone who injects opioids, such as heroin or fentanyl. People who may be at a higher risk include: anyone who has a reduced tolerance of opioids following detoxification, anyone with a suspected or confirmed history of substance abuse, dependence, or nonmedical use of prescription or illegal drugs. Do not use NARCAN Nasal Spray if you are allergic to naloxone hydrochloride or any of the ingredients in NARCAN Nasal Spray.

RECOGNIZING AN OPIOID OVERDOSE During an overdose, opiates overwhelm certain receptors in the brain, interrupting a key part of the body s impulse to breathe. Breathing slows dangerously or stops. Reversing this process quickly is crucial because without breathing and oxygen, brain damage or death can occur. Quickly recognizing the signs of an opioid overdose and acting appropriately could make all the difference. SIGNS INCLUDE: Will not wake up or respond to your voice or touch Breathing is very slow, irregular or has stopped Center part of their eye is very small sometimes called pinpoint pupils Fingernails and lips turning blue or purple Slow heartbeat and/or low blood pressure Not all of these signs will be present. If you suspect an opioid overdose, get emergency medical assistance right away. When used as directed, naloxone hydrochloride can reverse the effects of the opioids temporarily restoring breathing and wakefulness.

CAN I GIVE MYSELF NARCAN NASAL SPRAY? No. Treatment of suspected opioid overdose must be performed by someone other than the affected person. If you have or are prescribed NARCAN Nasal Spray, it s important to tell family, roommates, caregivers, friends and others around you where you keep NARCAN Nasal Spray (at home, on your person, in your car, etc.) and how and when to use it. Also, inform them that NARCAN Nasal Spray should always be given in accordance with the Instructions for Use, which are included in the package.

HOW TO GET For Patients, Family, Caregivers: ADAPT Pharma is committed to making NARCAN Nasal Spray affordable and accessible to everyone. ADAPT has entered into collaborations with wholesalers, distributors, and retail pharmacies to ensure broad-based availability. ADAPT has also entered into agreements with major Pharmacy Benefits Managers and insurance companies (including Medicaid) to make sure the cost to the patient is reasonable and affordable. Coverage of NARCAN Nasal Spray is provided by more than 90% of insurance plans nationwide. NARCAN Nasal Spray is a prescription product. However, there are many states where residents can purchase directly from a pharmacist without an individualized prescription. At BSMC patients may get a written prescription from the doctor to pick up at a pharmacy. If a patient has insurance they may have full coverage to receive naloxone. If a patient does not have insurance, speak with a member of the BSMC team to receive options for receiving naloxone.

HOW SHOULD I STORE NARCAN NASAL SPRAY? Store NARCAN Nasal Spray at room temperature between 59 F to 77 F (15 C to 25 C). NARCAN Nasal Spray may be stored for short periods up to 104 F (40 C) Do not freeze NARCAN Nasal Spray Keep the NARCAN Nasal Spray in its box until ready to use. Protect from light Replace NARCAN Nasal Spray before the expiration date on the box Keep NARCAN Nasal Spray and all medicines out of the reach of children

BEFORE I USE NARCAN NASAL SPRAY, DO I NEED TRAINING? DO I NEED TO ASSEMBLE NARCAN NASAL SPRAY OR MEASURE THE MEDICINE? There is no special training, measuring or assembly required to use NARCAN Nasal Spray. NARCAN Nasal Spray comes as a ready-to-use device that contains a single, pre-filled, premeasured dose of naloxone. NARCAN Nasal Spray should be used in accordance with the Instructions for Use contained in the Full Prescribing Information. The caregiver should familiarize her/himself with these instructions in order to be sure to administer NARCAN Nasal Spray properly.

WHAT IS THE MOST IMPORTANT INFORMATION I SHOULD KNOW ABOUT NARCAN NASAL SPRAY? NARCAN Nasal Spray is used to temporarily reverse the effects of opioid medicines. The medicine in NARCAN Nasal Spray has no effect in people who are not taking opioid medicines. Always carry NARCAN Nasal Spray with you in case of an opioid emergency. Use NARCAN Nasal Spray right away if you or your caregiver think signs or symptoms of an opioid emergency are present, even if you are not sure, because an opioid emergency can cause severe injury or death. Signs and symptoms of an opioid emergency may include: unusual sleepiness and you are not able to awaken the person with a loud voice or by rubbing firmly on the middle of their chest (sternum) breathing problems including slow or shallow breathing in someone difficult to awaken or who looks like they are not breathing the black circle in the center of the colored part of the eye (pupil) is very small, sometimes called "pinpoint pupils" in someone difficult to awaken Family members, caregivers, or other people who may have to use NARCAN Nasal Spray in an opioid emergency should know where NARCAN Nasal Spray is stored and how to give NARCAN Nasal Spray before an opioid emergency happens. Get emergency medical help right away after giving the first dose of NARCAN Nasal Spray. Rescue breathing or CPR (cardiopulmonary resuscitation) may be given while waiting for emergency medical help. The signs and symptoms of an opioid emergency can return after NARCAN Nasal Spray is given. If this happens, give another dose after 2 to 3 minutes using a new NARCAN Nasal Spray and watch the person until emergency help is received.

EVZIO AUTO INJECTOR EVZIO is the first and only intelligent take-home naloxone auto-injection system with voice and visual guidance designed to help caregivers take fast, confident action administering naloxone in an opioid emergency. EVZIO can temporarily reverse the effects of opioids and help keep a patient breathing until emergency medical assistance is available Get emergency medical help right away after the first dose of EVZIO, even if the person wakes up If symptoms return after an injection with EVZIO, an additional injection using another EVZIO may be needed Most life-threatening opioid emergencies occur in the home, witnessed by friends or family Lack of oxygen from an opioid emergency may lead to severe and permanent brain damage in as little as 4 minutes, yet the average EMS response time is 9.4 minutes according to the National EMS Information System

INTELLIGENT VOICE GUIDANCE: Simple, on-the-spot voice and visual guidance helps caregivers take fast, confident action administering naloxone during an opioid emergency and reminds the user to call 911 Each prescription includes a Trainer for EVZIO, allowing patients and caregivers to practice ASY TO USE: Studies show 94% of users correctly administered EVZIO without training, and 100% with training* SELF-CONTAINED SYSTEM: Prefilled, durable, and portable small enough to fit in most pockets Is administered intramuscularly or subcutaneously into the outer thigh, through clothing if needed

REFERENCES Narcan.com Evzio.com