Narcotic Antagonist

Question 1

Drug names

Answer 1

Naloxone

Naltrexone

Question 2

MOA

Answer 2

Drugs that bind strongly to opioid receptors, but they do not activate the receptors
Reverse effects of opioid

Question 3

Indications

Answer 3

Naloxone- Reversal of the adverse effects of narcotics

Naltrexone- Treat narcotic and/or alcoholic dependence

Question 4

Contraindications

Answer 4

Known allergy

Question 5

Cautions

Answer 5

Pregnancy and lactation
Narcotic addiction (w/d from narcotics)
CV disease (increase heart rate and blood pressure

Question 6

Drug-Drug interaction

Answer 6

Larger doses may be needed to reverse effects of:
◦ Buprenorphine
◦ Butorphanol
◦ Nalbuphine
◦ Pentazocine
◦ Propoxyphene

Question 7

Adverse Effects

Answer 7

Acute narcotic abstinence syndrome - pain, increased CV, opioid w/d
Nausea, vomiting, sweating
Tachycardia
Blood pressure changes
Dysrhythmias

Question 8

Nursing Process - Assessmnet

Answer 8

History and physical
◦ Allergies; history of narcotic addiction; history of MI or CAD; pregnancy and lactation
◦ Orientation, affect, reflexes, and pupil size; monitor respiratory rate and LS
◦ Monitor vital signs, including pulse and blood pressure
◦ Obtain an electrocardiogram

Question 9

Nursing diagnoses

Answer 9

Acute pain related to withdrawal and CV effects
Decreased cardiac output related to CV effects
Risk for injury related to CNS effects
Deficient knowledge regarding drug therapy

Question 10

Implementation

Answer 10

Maintain open airway and provide artificial ventilation
Administer naloxone challenge before giving naltrexone
Provide continuous monitoring of the patient
Ensure that patients receiving naltrexone have been narcotic-free for 7 to 10 days
If the patient is receiving naltrexone as part of a comprehensive narcotic or alcohol withdrawal program, advise the
patient to wear or carry a Medic Alert warning
Institute comfort and safety measures- fall precaution (side rails, bowel protocol)

Question 11

Patient teaching

Answer 11

ADE
Safety/ precautions
Needs to be continuously monitored
-Naloxone has a short life, may need to be readministered

Question 12

Evaluation

Answer 12

Pt response to drug (reversal or opioid effects, treatment of alcohol dependance)
Monitor common ADE (CV changes, arrhythmias, hypertension)