Naloxone (Narcan)

Question 1

Class / Action

Answer 1

Narcotic Antagonist

1. Binds to opiate receptor sites, displaces narcotic molecules from opiate receptors
2. May precipitate withdrawal symptoms in patients physically dependent on narcotics
3. Reverses respiratory depression S/T narcotic overdose

Question 2

Onset / Duration of Action

Answer 2

ONSET:
IV/IO/ET: 1-2min
IN: 3-4min
IM: 2-5min

DURATION:

1. Approximately 45min
2. Effects are variable with route and agent

Question 3

Indications

Answer 3

1. Respiratory Depression S/T narcotics, synthetic narcotic agents, and related drugs
2. Opiate overdoses such a Codine, Darvon, Demerol, Dilaudid, Fentanyl, Heroin, Hydrocodone, Methadone, Morphine, Nubian, Oxycodone, Percodan, Stadol, Talwin, etc.
3. Treatment of coma of unknown origin with apnea/hypo ventilation or in neonatal resuscitation

Question 4

Contraindications

Answer 4

Known Hypersensitivity

Question 5

Precautions

Answer 5

1. In pts known to be physically dependent on narcotics; may precipitate withdrawal symptoms
2. Be prepared to restrain potentially violent patients if necessary after administration

Question 6

Dosages / Administration

Answer 6

1. ADULTS: 0.4-2mg IN/IM/IV/IO/ET; Dose may be repeated every 2-3min, up to 10mg or until pt begins to maintain airway and breath adequately
   a. It is not necessary to wake the pt; Just give enough to make them breathe on their own
2. ADULTS: If no response is observed after 10mg, consider different etiology of respiratory depression or unconsciousness
3. ADULTS: Higher Doses may be ordered if no initial response
4. PEDS: 0.1mg/kg IN/IM/IV/IO/ET up to 2mg/dose; May be repeated q 2-3min, up to 10mg or until pt begins to maintain their own airway and breathe adequately

Question 7

Adverse Reactions

Answer 7

Withdrawal Symptoms: Sweating, Gooseflesh, Tremor, Nausea and Vomiting, Dilation of pupils, Tearing of eyes, Agitation, Belligerence, Convulsions, Hyper- or Hypo-ventilation