When a patient shows signs of opioid overdose, what reversal agent might be ordered and how should this be reflected in the MAR?

• A. Naloxone; document time, dose, route, and patient response, and notify clinician
• B. Flumazenil; document only the dose
• C. Activated charcoal; document time
• D. Vitamin K; document route and time

Answer: (A)

Reversing opioid overdose requires naloxone, an opioid receptor antagonist that rapidly displaces opioids and reverses respiratory depression. In the MAR, document the exact time of administration, the dose given, the route (such as IV, IM, or intranasal), and the patient’s response (for example, improved respirations or level of consciousness). Notify the clinician promptly because the patient may need additional doses or other interventions. Naloxone is the appropriate reversal agent for opioids; the other agents listed do not reverse opioid effects—flumazenil reverses benzodiazepines, activated charcoal is a decontamination measure for certain ingestions, and vitamin K reverses anticoagulation with warfarin.