According to the module this week the leading causes of death of Hispanics are heart disease, cancer, COPD, diabetes, and HIV/AIDS. The module also provides us with the following information about the Hispanic population: heart malady and cancer are the two driving causes of passing in Hispanics bookkeeping for 2 out of 5 deaths which are near to that of whites. In any case, Hispanics have more deaths from diabetes and constant liver illness than whites. HIV/AIDS is the third driving cause of death for Hispanic men and fourth for Hispanic ladies. Many health disparities cause challenging times. Health disparities are challenges; however, addressing these disparities is a challenge as well. With communications barriers and cultural barriers involved, working as an APNs options such as these are available, interpreters, helping patients to overcome communications barriers to educate the patient on the actions they need to take for their health and longevity. According to the Journal of the National Society of Allied Health, many patients were a part of the Hispanic/Latino community along with being middle-aged, married female who mostly spoke Spanish with a primary level of education, unemployed, access to a phone, did not drink or smoke, seeks medical treatment about 5 times per year, and took around 2 prescriiptions (Absher et al., 2018). Absher et al. (2018) also talk about how 92.5% of the patients with chronic diseases, 57.5% uncontrolled obesity levels, inadequately controlled diabetes or prediabetes of 58.5%, hypertension, arthritis, and other medical conditions. In the Clinical Journal of Oncology Nursing, reports show the increase of Hispanic representation in clinical trials will provide better awareness on effective treatment and therapies for making improvements on the Hispanic population and other populations at risk (Petty, 2019).
Naloxone is the reversal agent used in opioid overdose, therefore the medication antagonizes various opioid receptors. The half-life is 1.07-1.53 hours (Epocrates, 2021). Naloxone works in the body for 30 to 90 minutes while opioids stay in the system longer than that; consequently, the patient may experience symptoms of overdose after naloxone wears off and/or additional doses may be needed. There are three FDA approved formulations including injectable, autoinjectable, and prepackaged nasal spray. The injectable formulation is primarily used by medical professionals and usually is administered intramuscularly; although, it can also be administered intravenously or subcutaneously. Police officers, emergency medical staff, and first responders are trained on administering naloxone (National Institutes of Health, 2020). The autoinjectable, Enzio, is a prefilled injection making it convenient for emergency workers and families to use. Prepackaged nasal spray, both Narcan and Enzio, include two doses which allows for repeat doses to be administered if needed. Regulations vary depending on the state you reside in as some require naloxone to be prescribed by a physician; other states allow outpatient pharmacies to disperse naloxone without a prescriiption enabling family members to give the autoinjector or nasal spray to someone who overdosed (National Institutes of Health, 2020).
Naltrexone is an opioid antagonist and has been approved by the FDA for treatment of opioid use disorder (OUD) and alcohol use disorder (AUD). The half-life is 4-5 hours as a parent drug and 13-14 hours as an active metabolite (Epocrates, 2021). This drug is a medication assisted treatment (MAT) which can be prescribed and administered by a licensed provider. This medication is not an option for anyone younger than 18 years old or experiencing other medical conditions. Naltrexone is one element of a comprehensive treatment plan to assist the patient holistically and includes both counseling and other behavioral health therapies. Naltrexone is prescribed in pill form for AUD and is available as an extended-release intramuscular (IM) injectable form for both alcohol use and opioid use disorder (Substance Abuse and Mental Health Services Administration). In addition, a Risk Evaluation and Mitigation Strategy (REMS) is required when prescribing the long acting IM form to make sure benefits outweigh the risks. Naltrexone works by blocking the euphoric and sedative effects of opioids; it blocks and binds opioid receptors which reduces and diminishes cravings of opioids. Naltexone does not have risk of abuse or diversion (Substance Abuse and Mental Health Services Administration).
Buprenorphine/Naloxone works to treat OUD. Buprenorphine, a partial opioid agonist, is the active drug in buprenorphine/naloxone. Therefore, the drug works partially like an opioid and the effects are weaker than full agonists such as methadone or heroin. Buprenorphine/Naloxone reduces opioid symptoms of withdrawal and cravings without having full opioid potency. Naloxone is an opioid antagonist thus acts as an opioid abuse deterrent. This assists patients from refraining from using other opioids (Substance Abuse and Mental Health Services Administration, 2021). The half-life for buprenorphine is 20-44 hours and the naloxone 1.07-1.53 hours (Epocrates, 2021). Buprenorphine/Naloxone is offered in tablet or film formulation that dissolves orally. Tablet form is sublingual and dissolved under the tongue completely, without swallowing. The film formulation also should be placed under the tongue and dissolved completely. The starting dose of buprenorphine/naloxone recommended is 8mg/2mg and adjusted under the supervision of certified health care provider with close monitoring (Substance Abuse and Mental Health Services Administration, 2021)