The key clinical features of the scenario that lead to administering of oxygen included;
- Post cardiac arrest
- Low blood oxygen levels
- Chronic and acute hypoxemia
- Symptoms of shock
- Low cardiac output
- Low metabolic acidosis
- Chronic type two respiratory failures (Belsen 2012).
Based on the prevailing condition, the physiological rationale for administering oxygen was;
- To gain informed consent.
- To provide reassurance and psychological support.
- To ensure maximum benefit is obtained from treatment.
- Environmental and physiological humidifications are sufficient.
- All the care should be ensured that it is only delivered on a given individual basis.
- To allow detection of increase work of breathing.
- Head bobbing demonstrates the use of the stern mastoid muscle with each breath.
- Sign of severe respiratory distress.
- Indication of reduced blood oxygen levels (Eric 2012).
On administering of oxygen, it was expected to incorporate higher oxygenation of the blood, and tissue appears in order to stimulate cell functioning, this process usually facilitates the ability of the cells to heal and be able to fight infection. In addition, oxygen therapy normally promotes and stimulates the growth and development of new blood vessels (John 2012). Hyperbaric oxygen therapy also offers a stable platform for reduced swelling, thereby, reducing by a greater percentage the damage and harm from acute brain injuries.
On analyzing the scene of incidence, the possible risk factors included;
- Poor lifestyle
- Sensory/ communication impairment
- Hazardous environment (John 2012).
Based on personal perspective, these could be the recommendation and consideration based on the scene to ensure safety;
- Include the need for sufficient oxygen
- Need for proper nutrition
- Optimum temperature
- Cleaning of the entire area and room
- Create awareness of the adverse effects of drugs and the safety requirement
Mechanism by which an opioid agonist (such as heroin), causes respiratory depression (Jerome 2007).
Based on the current generation, drug addiction is a worldwide problem of opioid dependence. Most addicts inject opioid with dirty and shared syringe. The pharmacodynamic response to an opioid usually has a base on the receptors that bind it, its affinity and affection for that receptor, and mostly whether the respective opioid is an agonist or an antagonist respiratory depression and physical dependence by the μ2 receptor. It contains Buprenorphine hydrochloride which is an established, active substance. Buprenorphine hydrochloride is designated chemically as (2S)-2-[17-Cyclopropylmethyl-4, 5α-epoxy-3-hydroxy-6-methoxy-6α, 14-ethano-14α-morphinan-7α-yl]-3, 3 dimethylbutan-2-ol hydrochloride
Pharmacodynamic rationale for administering naloxone
Naloxone is intended to be administered cautiously to persons. Considering such scenarios, a rapid and complete reversal of narcotic effects may gradually generate an extremely acute and severe abstinence syndrome that may affect the person. The acuteness and seriousness of that syndrome highly depends upon the degree of physical addiction and the dose of antagonist administered. In the case of serious respiratory depression in a physically addicted individual, the antagonist, when indicated, is supposed to be administered with extreme care and caution, it should be closely monitored, with the aid of appropriate titration with minimal doses than usual. The patient who has successfully managed to respond to naloxone should be always monitored and left under surveillance, and a series of repeated doses should be administered, as necessary, this is due to reason that the duration of some narcotics action may exceed that of naloxone.
Mechanism of action of naloxone
Naloxone is famously known for its vehement ability in prevention and reversal of the effects of opioid such as the adverse effect of respiratory depression. It consists of essentially pure narcotic antagonist which lacks the agonistic unlike other narcotic antagonists’ exhibit as property characteristic. It also exhibits essentially no pharmacological activity which restricts it from producing respiratory depression. According to the recent research carried out on its mechanism of action, it has been depicted that naloxone antagonizes the opioid effects simply by competing for the same receptor sites (Nathan 2012).
Its onset of action is generally apparent within 2 minutes after naloxone i.v. has been administered.
Pharmacological considerations of current approaches to narcotic overdose
For the partial reversal of narcotic depression based on the use and management of narcotics during surgery, minimal doses of naloxone are extremely sufficient. The dose is expected to be titrated based on the patient's response. For the initial reversal of respiratory depression, naloxone should be injected gradually in increments of 100 to 200 µg (0.1 to 0.2 mg) i.v. at 2 to 3 minute intervals until the optimum degree of reversal is attained. Adequate ventilation and alertness without significant pain or discomfort should be realized. Overdose of naloxone may results in complicated reversal of analgesia and also rise in one’s blood pressure levels. On the other hand, in case there is reversal conducted in a rapid manner, it may result in constant nausea, frequent vomiting, and sweating (Tracy 2012).