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A review of current practice and administration. Refer to Lexi-Comp for more detailed information.
Administration/Monitoring
Precautions
AHS ED Indication
Administration
Sublingual tablets:
Place under the tongue until dissolved
If 2 or more tablets are needed per dose, can place all
under the tongue at once or 2 tablets at a time
Common ED Doses
Sublingual: 2-8mg x1
Injectable (IV or IM): 0.3mg x1
Transdermal: 5-20mcg/h
Monitoring
Same monitoring as with any other opioid; watch for
respiratory depression, and hypotension
Injectable:
IV push over at least 2 minutes
Administer by deep IM injection
Transdermal Patch: (patient should stop other opioids)
Slow onset; low risk of precipitating withdrawal in most
cases. May need bridge of analgesia for first 24 hours.
Clean area with water only and allow to dry completely
Examine patient for any old patches and remove
Ensure skin site is non-irritated and hairless
To apply: 1) Remove the protective backing 2) place
sticky side of the patch to the upper outer arm, upper
chest, upper back or side of the chest 3) firmly press and
hold patch in place for ~15 sec
Label patch with date, time, and initials
Contraindications
Hypersensitivity
May have cross-sensitivity with other opioids
High risk of precipitated withdrawal among
methadone users
Derex Louie PharmD, Tina Liu, PharmD, Andrew Herring, MD, JFProvinse, MS, RN 7/16 References: Lexi-Comp for buprenorphine accessed 6-28-16