# naproxen and narcan



## jgmedic (Dec 3, 2012)

Quick question. I had a minor disagreement with an FD medic who gave narcan in a patient who had apparently taken naproxen. He told me that it acted on the same receptors as narcotics and so narcan was indicated. Patient was not resp depressed and mildly ALOC with etoh on board. Has anyone ever heard of this? He stated it was told to him by a physician.


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## Clare (Dec 3, 2012)

Naproxen is a COX inhibitor (heehee, COX inhibitor) and appears to have no effect on the opioid receptors therefore naloxone is not going to do anything for somebody who has taken it.  

Maybe he was thinking of nubain or something? who knows


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## Aprz (Dec 3, 2012)

Naproxen (naprosyn) is an NSAID (COX inhibitor like Clare said) like aspirin, toradol, mobic, etc. so no, it does not act on the same receptor (naloxone antagonize the opiate receptors). Additionally like you said, no respiratory depression, which is the reason you'd give naloxone (narcan). The goal is not to take away their high or wake them up, it's to get them to breath reasonably on their own. He was wrong.


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## RocketMedic (Dec 3, 2012)

Lol @ FD medic.


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## NYMedic828 (Dec 3, 2012)

jgmedic said:


> Quick question. I had a minor disagreement with an FD medic who gave narcan in a patient who had apparently taken naproxen. *He told me that it acted on the same receptors as narcotics and so narcan was indicated*. Patient was not resp depressed and mildly ALOC with etoh on board. Has anyone ever heard of this? He stated it was told to him by a physician.









Medic should be sent for re training!


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## JPINFV (Dec 3, 2012)

Sorry... I'm allergic to [BS]


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## sdadam (Dec 3, 2012)

No way, no how.

He may have been mistaking Naproxen for Norco? Maybe?


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## jgmedic (Dec 3, 2012)

sdadam said:


> No way, no how.
> 
> He may have been mistaking Naproxen for Norco? Maybe?



No, he referred to Naproxen and Midol and other similar drugs, saying how it was a trick some dr. had told him about. He gave the Narcan to the patient who then started vomiting all over the back of my rig. He then rode in with me, claiming something about pinpoint pupils. All of this doesn't even matter, considering even if he was right, the patient didn't have any respiratory depression, so the Narcan was not even indicated(per our protocol), the patient also exhibited way more signs of stimulant use than opiates.

Just to be perfectly clear here, I was asking more to vindicate myself here when I told him what he was doing was wrong and he condescendingly told me otherwise, I am well aware of what it doesn't work on, I had almost the same argument with a medic a number of years ago regarding Narcan in Soma OD. Thanks for all the responses and I will be sure to pass some of this on.


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## Summit (Dec 3, 2012)

wow.........


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## mycrofft (Dec 3, 2012)

"*saying how it was a trick some dr. had told him about"*

And there, ladies and gentlemen, is exactly, _EXACTLY,_ why technicians work with protocols.

What idiocy.


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## mycrofft (Dec 3, 2012)

*And re SOMA (carisporodol)*

http://toxnet.nlm.nih.gov/cgi-bin/sis/search/a?dbs+hsdb:@term+@DOCNO+3021

No mention of Narcan for treatment.


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## TheLocalMedic (Dec 3, 2012)

LOL, you said he rode in with you?  Did you get to watch as he explained himself in the ED?  
:rofl:


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## Summit (Dec 3, 2012)

TheLocalMedic said:


> LOL, you said he rode in with you?  Did you get to watch as he explained himself in the ED?
> :rofl:



That would have been a scene to behold...


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## jgmedic (Dec 3, 2012)

TheLocalMedic said:


> LOL, you said he rode in with you?  Did you get to watch as he explained himself in the ED?
> :rofl:



After he left all the nurses just stared and shook their heads. It's not an uncommon scene when fire decides to step in and do things like this. Most of the FD medics around here are cool too, but there's always a couple.


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## TheLocalMedic (Dec 3, 2012)

I haven't had too many bad experiences with the fire guys in my area, but there are plenty of people with stories.  One apparently walked in to find a fire medic about to give 1 mg of eip 1:1,000 IV to a girl with a case of poison oak.  YIKES!  :wacko:


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## intellectualfish (Dec 3, 2012)

I remember a call from a ride along I did during my basic course with the local, private 911 company where the FF medic on scene was trying to give a CHF pt albuterol because he could, "hear wheezing that sounds like asthma." Mind you, this pt has zero hx of asthma, extensive cardiac hx, and dependent edema in the lower extremities. Unfortunately, the way things work around here, FF medics are in charge of the scene until the pt is in the back of the transport ambulance. After much protesting by the transport medic, his partner, and me, the FF medic starts the neb and helps load the pt. Neb goes straight into the trash as soon as the doors close on the rig. Sometimes I wonder about these folks. Heck, I didn't even have my basic yet and knew this was a bad combo...


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## STXmedic (Dec 3, 2012)

I've got plenty of stories about ambo medics doing really stupid :censored::censored::censored::censored:, too. Just sayin.


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## Tigger (Dec 3, 2012)

PoeticInjustice said:


> I've got plenty of stories about ambo medics doing really stupid :censored::censored::censored::censored:, too. Just sayin.



Beat me to it.


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## jgmedic (Dec 4, 2012)

PoeticInjustice said:


> I've got plenty of stories about ambo medics doing really stupid :censored::censored::censored::censored:, too. Just sayin.



no doubt, I didn't mean to come off like Fire is the only one who does dumb stuff medically. Usually they don't ride in and give report, so when they do, it comes off kind of awkward, considering we do it 8-9x a night and they a few times a year unless they work out in the desert on one of their boxes. I would have been just as upset with the situation if it had been one of our medics telling me this.


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## VFlutter (Dec 4, 2012)

Why did he want to reverse Naproxen in the first place? Did they chug a whole bottle?


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## KellyBracket (Dec 4, 2012)

There's a short list of non-opiod drugs that naloxone has some effect on. It partially treats the hypotension in *cloninde* OD, for example, or the mental status depression with an *Afrin* OD!

That being said, I doubt that an ER doc reads the British Journal of Pharmacology, but I did find this one (absolutely clinically irrelevant) study:
*Reversal by naloxone of the spinal antinociceptive actions of a systemically-administered NSAID*


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## STXmedic (Dec 4, 2012)

Some good reading; thanks Kelly


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## mycrofft (Dec 5, 2012)

Naloxone acts on the endogenous opioids? Got it. NSAID is not a direct opioid agonist? Got that. 


Going to OP, could it be that the drug the reporting firefighter meant to report was not Naprosyn but something else?


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