Wednesday, October 20, 2021 2:03:22 PM
Message in reply to:
66, I’m not certain. I’ve been out of the prehospital arena since 2010, but within that timeframe I was a paramedic, I had almost always seen a single dose of Narcan work well. But that was mostly oxycodone and heroine ODs.
That said, my medic time was before the current epidemic street use of fentanyl and doping of other drugs with Remifentanyl. Those two drugs could perhaps create the situation you mention, as narcan is a Competitive Antagonist. Essentially Narcan (naloxone) competes for binding sites with opioids. An extra dose of opioids (or in this case, perhaps a stronger opioid) has a greater chance of overwhelming the Narcan.
As an aside, a non-competitive antagonist for Benzos (Valium, etc) is Romazicon. You could dump benzos in after, but they cannot bind.
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