Naloxone Hydrochloride

Question 1

Class

Answer 1

Opioid Antagonist, Antidote

Question 2

Mechanism of Action

Answer 2

Competitive inhabitation at narcotic receptor sites. Reverses respiratory depression to opiate drugs. Completely inhibits the effects of morphine.

Question 3

Indications.

Answer 3

Opiate overdose, complete or partial reversal of CNS and respiratory depression induced by opioids, decreased level of consciousness, coma of unknown origin. Narcotic agonisit for the following: Morphine sulfate, heroin, hydromorphone (dilaudid), methadone, meperidine ( demerol), paregoric, fentanyl ( sublimaze), oxycodone ( percodan), codeine, proxyphene ( darvon). Narcotic agonist and antagonist for the following: butorphanol (stadol), pentazocine (talwin), nalbuphine ( nubain)

Question 4

Contraindications

Answer 4

Use with caution in narcotic - dependent patients. Use with caution in neonate of narcotic - addicted mothers.

Question 5

Adverse reactions / side effects

Answer 5

Restlessness, seizures, dyspnea, pulmonary edema, tachycardia, hypertension, dysrhythmias, cardiac arrest, nausea, vomiting, withdrawal symptoms in opioid addicted patients, diaphoresis.

Question 6

Drug interactions

Answer 6

Incompatible with bisulfite and alkaline solutions.

Question 7

Adult dose / route

Answer 7

0.4 to 2 mg IM/ IV/IO/ Subcutaneous/ET/IN ( diluted); minimum single dose recommended: 2 mg. Repeat at 5 minutes intervals to a maximum total dose of 10 mg ( medical control may request higher amounts). For IN route, administer half the dose in each nostril; maximum dose is 1 mL per nostril.

Question 8

Pedi dose / route

Answer 8

0.1 mg / kg per dose IV/IO/IM/ET every 2 minutes as needed. Maximum total dose of 2 mg. If no response in 10 minutes, administer an additional 0.1 mg/kg per dose.

Question 9

Duration of action

Answer 9

Onset: Less than 2 minutes. Peak effect: Variable. Duration: 30 to 60 minutes.

Question 10

Pregnancy class

Answer 10

C

Question 11

special considerations

Answer 11

Any use during pregnancy, use in breastfeeding women should be clearly indicated. Assist ventilations prior to administration to avoid sympathetic stimulation. Seizures without casual relationship have been reported. May not reverse hypotension. Use caution when administering to narcotic addicts ( potential violent behavior). Half - life of naloxone is often shorter than the half life of narcotic; repeat dosing may be required. In cardiac arrest, naloxone is generally not beneficial