Naloxone (Narcan)

Category:

  • Miscellaneous

Description:

  • Opiate antidote

Indications:

  • Complete or partial reversal of narcotic depression, including respiratory depression

  • Diagnosis of suspected acute opioid overdose

Precautions:

  • Pregnancy category B

  • Physical narcotic dependency

  • Pre-existing cardiovascular disorders

Adverse Reactions (Side Effects):

  • CNS: seizures, tremulousness

  • CV: hypertension, hypotension, tachycardia, ventricular dysrhythmia

  • GI: nausea, vomiting

  • RESP: pulmonary edema

  • SKIN: sweating

  • MISC: reversal of anesthesia

Dosage:

Administered subcutaneously, intramuscularly, intravenously

  • Adult:            

    • Narcotic overdose (known or suspected): 

      • SC/IM/IV 0.4-2mg initially, repeat at 2-3 minute intervals up to 10mg, if no response after 10mg reevaluate diagnosis

    • Postoperative narcotic depression (partial reversal): 

      • IV 0.1-0.2mg at 2-3 minute intervals to desired level of reversal; repeat doses may be required within 1-2 hour intervals

  • Child:            

    • Narcotic overdose (known or suspected): 

      • SC/IM/IV 0.01 mg/kg initially, give subsequent doses of 0.01 mg/kg as needed at 2-3 minute intervals

    • Postoperative narcotic depression (partial reversal): 

      • IV 0.005-0.01mg every 2-3 minutes to desired degree of reversal

Consideration:

  • Duration of action of some narcotics may exceed that of naloxone; repeat doses as needed

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