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0 Attached is a template standing order that will be used by CDPHE in response to these requests. Stay with the person until medical help arrives. If there is no change to the person’s condition after 2-3 minutes, give another dose of naloxone (if available) as in Step 4 above and continue rescue breathing or CPR as indicated. ����\F,pa �U�����}����w>�l�XJ'�a@;�U�X*'/�5~�y����[RlW_�k�%�E_~��U�+T�~��c�Y���:9��q�XzN�-��u������x{�_hg��pG�o�)!.�#�oh8��~Elo������v�x�1+�a �g}���������U��~q^�o.Am���u����3C��d�}���`C�d�^'ʕg$���P�σ�̴����M��7“�W�B��xP���ސ7��Oq��@!���E�%��bi ��X��u��r��`�m�! <> 299 0 obj <> endobj endstream endobj startxref It should not be given to anyone known to be hypersensitive to naloxone hydrochloride. Standing Order for Dispensing of Naloxone Insert Pharmacy Name Here Naloxone is indicated for the reversal of opioid overdose induced by natural or synthetic opioids in the setting of respiratory depression or unresponsiveness. This standing order is issued pursuant to Act 2016-307, which authorizes the State Health Officer to prescribe naloxone via standing order. The local prescriber standing order is for pharmacies interested in using their own medical provider to issue a prescription order for naloxone. NALOXONE STANDING ORDER Naloxone is indicated for the reversal of opioid overdose induced by natural or synthetic opioids in the setting of respiratory depression or unresponsiveness. Naloxone Standing Order. <>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 21 0 R] /MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> 3 0 obj %PDF-1.6 %���� h�b``�b``�f`a`Hsb`@ FV�8Nj 5��)B[�/I�0�*������Ͱ'Y� X1�4�2���@, `�f�g`�w��� r��!�a!�:�%� l��Nfxh���Ljc��i�I��XT��)c`��� t�=�+�t� �� )�+E 325 0 obj <>/Filter/FlateDecode/ID[<73CCF32C72E7624A9D6B4EF82E34D7D8><4D3636827DA92B42A4C9E22A88D855EF>]/Index[299 52]/Info 298 0 R/Length 123/Prev 405100/Root 300 0 R/Size 351/Type/XRef/W[1 3 1]>>stream endobj d. Spray half (1ml) of the Naloxone in one nostril and the other half (1ml) in the other nostril. After conducting interviews with LHDs and statewide partners working to prevent drug overdose, the Injury and Violence Prevention Branch’s (IVPB) Capstone team created this digital toolkit to assist LHDs with easily creating standing orders for naloxone dispensing and distribution. This should be used as a template or a guide. resource, or readiness to adopt a standing order for naloxone. Local Prescriber Naloxone Standing Order for Pharmacists, F-01802A (Word) In order to be eligible for a local prescriber standing order, all pharmacists dispensing naloxone under the standing order must … Home → Resources → Naloxone Standing Order. %%EOF Ill. More in this section. �&]�R����h��;�0{u q�t�lҀ¤�.�./�C��jO���w�x�p_�����(��dU���d =5=mc�ç6y$$=ad h�bbd```b``� "�A$c5�d��LS��6X�"�m&]��X�N���&���`����&D*��z �O̞"�;A��'�dT����I20120����qP���0 )| 8. x��[�s������̘g��N&S[�kw�X���C��@"(bJ�@Jq���.��@�q& �{{����!�]^�{�f~ ��LH�5�J�������Xvy�^޲�����5s�����b�ͤ}}wy��`BpW����`.�#aȵr�����p��{�o�vy���fw���>�����^D0�_O����`Zv��>��^ e. Note: Administer the Naloxone in a quick burst to ensure that it is atomized. stream It is contraindicated in patients known to be hypersensitive to naloxone hydrochloride. 4IDOH NALOXONE STANDING ORDER-DOH-001 . 1 0 obj How to Report Naloxone without a DEA Number; A slow administration will cause liquid to trickle in without being atomized � yd1Lp��B� ���Ii�EI� �e�NA���`����. rj"��P���X�3�@��Ї��t��ѿ5�zW��4V{eY��.﻾��Zd��ޗ�y1������ty��ZxCr�7b��. 4 0 obj endobj Notify EMS of naloxone administration. It is Standing Order Information Law enforcement officers can contact cdphe_naloxone@state.co us to request a Standing Order for naloxone prescriptions. AUTHORIZATION This standing order may be used as a prescription to obtain naloxone from a pharmacy in the event there is an inability to obtain naloxone or a prescription for naloxone from an eligible endobj These standing orders are intended law enforcement officers that do not have their own medical providers. '�PJ����a�g"௮�����P�c��� .� %PDF-1.5 350 0 obj <>stream Resources. The standing order authorizes a pharmacist that is active and in good standing with the Texas State Board of Pharmacy to dispense an opioid antagonist to a recipient in any of the following formulations: Intramuscular Naloxone aqueous solution multi-dose vial or pre-filled syringe (EXCLUDING auto-injector such as Evzio or equivalent); Standing Order for Administration of Naloxone <>>> <> This standing order covers the possession and distribution of naloxone kits, to include naloxone %���� Those who do have h޴WmO9�+���l�_�TEJH�z�"��.ʇ@�aua7J��r����(*(B��ޙ�x�<3C^(a(�5�(4�d1%���p�a$|�hD�F=,��y�m"���3���{����X�e"m��gI����AQ���e^0іe�D`����0�p�XL�{�Fz{�8_|���>��\���)>�-/�YQ���ap4�.o���ەGUY�{ҧ���{:���5",T��z/,O��K^�B��g7�\���,_�s���L� endstream endobj 300 0 obj <> endobj 301 0 obj <>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/Rotate 0/Type/Page>> endobj 302 0 obj <>stream 2 0 obj Administering Immunizations & Medications; Board of Medicine Regulations; Clinical Information & Links; Community Health Worker Resources; Naloxone Standing Order.


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