Naloxone

Question 1

What is the brand/trade name for naloxone?

Answer 1

• Narcan

_{Anesthesia Guidebook - Episode 19: Anesthesia Top Drawer Run Down - Part 3
UpToDate - Propofol: Drug Information}

Question 2

What is the pharmacologic category/class of naloxone?

Answer 2

• nonselective opioid receptor antagonist

_{Anesthesia Guidebook - Episode 19: Anesthesia Top Drawer Run Down - Part 3
UpToDate - Naloxone: Drug Information}

Question 3

What is the mechanism of action of naloxone?

Answer 3

• competetive antagonism of opioids at the mu, kappa, and delta receptors

_{Anesthesia Guidebook - Episode 19: Anesthesia Top Drawer Run Down - Part 3
UpToDate - Naloxone: Drug Information}

Question 4

What is the recommended dosing of naloxone for reversal of opioid overdose/opioid induced respiratory depression?

Answer 4

• 40-200 mcg slow push q2-3 min prn
  _{larger single doses (up to 2mg) are possible for life threatening overdose but most sources recommend starting low and titrating slow}
• Max dose = 10 mg

some side effects appear to be related to dose/speed of administration

_{Anesthesia Guidebook - Episode 19: Anesthesia Top Drawer Run Down - Part 3
Apex Unit 5: Pharmacology 2; Opioid & Non-Opioid Analgesics; Lesson 12. Opioid Antagonists
UpToDate - Naloxone: Drug Information}

Question 5

What is the infusion dose of naloxone?

Answer 5

• 0.4 mg/hr titrated to effect

_{Dr. C
Pocket Anesthesia (5th)}

Question 6

What is the onset of action for naloxone?

Answer 6

• 1-2 minutes

_{Anesthesia Guidebook - Episode 19: Anesthesia Top Drawer Run Down - Part 3}

Question 7

What is the duration of action for naloxone?

Answer 7

• 1-4 hours

Be mindful that duration could be shorter than some opioids…

_{Anesthesia Guidebook - Episode 19: Anesthesia Top Drawer Run Down - Part 3}

Question 8

What organ(s) are responsible for naloxone’s clearance (metabolism/elimination)?

Answer 8

• Metabolism: Liver
• Elimination: Kidneys, also present in bile

_{Anesthesia Guidebook - Episode 19: Anesthesia Top Drawer Run Down - Part 3}