A nurse is providing discharge teaching to a client with an opioid use disorder who will be initiating home induction of buprenorphine/naloxone therapy. To prevent precipitated withdrawal and ensure maximum medication absorption, the nurse should instruct the client to perform the administration steps in which order? Arrange the items from first to last.
- 1Abstain from using short-acting opioids for at least 12 to 24 hours.
- 2Wait until experiencing objective signs of mild-to-moderate withdrawal, such as sweating or restlessness.
- 3Place the prescribed film or tablet directly under the tongue.
- 4Allow the medication to dissolve completely without chewing or swallowing.
- 5Refrain from eating or drinking for at least 15 minutes after the dose.
Answer
The correct sequence begins with opioid abstinence, followed by verifying withdrawal symptoms, placing the medication sublingually, letting it dissolve completely, and finally waiting before oral intake.
Buprenorphine is a partial opioid agonist with a high receptor affinity. Proper home induction requires the client to first abstain from opioids and wait for the onset of mild-to-moderate withdrawal to prevent precipitated withdrawal. Once safe to administer, the medication must be placed sublingually, allowed to dissolve completely without chewing, and left undisturbed by food or drink to ensure mucosal absorption and bypass first-pass hepatic metabolism.
Step-by-Step Solution
Key Concept
Home induction of buprenorphine requires precise timing based on withdrawal onset to prevent precipitated withdrawal, followed by strict sublingual administration protocols to ensure absorption.