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Narcan

Naloxone Hydrochloride
(Narcan®)

CLASS

Synthetic opioid antagonist

DOSAGES

    Adult: An initial dose of 2-4 mg may be administered IV, IN, IM, SC, or ET.
    May repeat in 2-3 minutes.
    If no response after 10mg, then condition is probably not due to narcotic.

    Larger doses of naloxone may be required to reverse toxicity from diphenoxylate/atropine (Lomotil), methadone, propoxyphene, pentazocine, and the fentanyl derivatives.

    Pediatric: 0.1 mg/kg IV, IM, IO, ET or SC.
    May repeat with 0.1 mg/kg if no improvement is noted.

ACTIONS

    The mechanism of action is not fully understood. It does appear that Naloxone antagonizes the effects of opiates by competing at same receptor sites. When given IV, the action is apparent within two minutes. IM or SC administration is slightly slower.

INDICATIONS

    Naloxone is indicated for the complete or partial reversal of opiate narcotic depressionand respiratory depression secondary to opiate narcotics or related drugs:
      - Codeine
      - Morphine
      - Methadone
      - Lomotil
      - Pentazocine (Talwin)
      - Propoxyphene (Darvon)
      - Percodan
      - Fentanyl (Sublimaze) (Known on the street as white china).
      Naloxone can also be used for suspected acute opiate overdosage.

    Narcotic agonist:
    - Morphine Sulfate Heroin
    - Hydromorphone (Dilaudid) Methadone
    - Meperidine (Demerol) Paregoric
    - Fentanyl citrate (Sublimaze) Oxycodone (Percodan, Percocet)
    - Codeine Propoxyphene (Darvon, Darvocet)

    Narcotic agonist and antagonist Butorphanol tartrate (Stadol)
    - Pentazocine (Talwin)
    - Nalbuphone (Nubain)

CONTRAINDICATIONS

    Naloxone is contraindicated in patients known to be hypersensitive to it.

    Use with extreme caution in narcotic-dependent patients who may experience withdrawal syndrome (including neonates of narcotic-dependent mothers).

Is incompatible with bisulfite and with alkaline solutions.

SIDE EFFECTS

    CNS:Tremor, agitation, belligerence, papillary dilation, seizures, increased tear production, sweating, seizures secondary to withdrawal.

    Cardio:Hypertension, hypotension, ventricular tachycardia, pulmonary edema, ventricular fibrillation.

    GI:Nausea, vomiting.

WARNINGS

    Naloxone should be administered cautiously to persons including newborns of mothers who are known or suspected to be physically dependent on opiates may precipitate an acute abstinence syndrome. May need to repeat Naloxone is not effective against a respiratory depression due to non-opiate drugs. Use caution during administration as patient may become violent as level of consciousness increases.

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