Opioid Antagonists (Exam 2) *Quick Review*

Question 1

Opioid Antagonist Meds

Answer 1

• Naloxone
• Naltrexone
• Nalmefene
• Methylnaltrexone
• Alvomopan

MANNN

Question 2

Naloxone (Narcan): Clinical Uses

Answer 2

‣Hypovolemic/septic shock
(increased contractility)

‣Antagonism of general anesthesia at high doses

Question 3

Naloxone (Narcan): Dose

Answer 3

• 1-4 µg/kg
• Infusion: 5 µg/kg
• > 1 mg/kg IV (shock)
  epidural s/e: 0.25 µg/kg/hour IV

**continuous infusion for patients who are on opioids that last for HOURS.

-GIVE PUSHES SLOWLY 2-3 MINUTES!

Question 4

Naloxone (Narcan): Duration

Answer 4

• 30-45 min

-MOST OPIOIDS WILL OUT LAST THIS!

-WILL HAVE TO REDOSE OR YOU CAN DO EPIDURAL INFUSION

Question 5

Naloxone (Narcan): MOA

Answer 5

nonselective with all 3 opioid receptors

Question 6

Naloxone (Narcan): E 1/2 Time

Answer 6

60 - 90 Mins

Question 7

Naltrexone: Clinical Uses

Answer 7

Alcoholism

Question 8

Naltrexone: Duration

Answer 8

24 hours

Question 9

Nalmefene: Dose

Answer 9

EQUI-POTENT to NALOXONE
-15-25 µg IV
q 2-5 min up to 1 𝝻g/kg

Question 10

Methylnaltrexone: Clinical Use

Answer 10

-Promotes gastric emptying and antagonizes n/v

-DOES NOT ALTER CENTRAL MEDIATED ANALGESIA

Question 11

Alvomopan: Clinical Use

Answer 11

Post op ileus

Question 12

Alvomopan: side effects

Answer 12

cannot use long term b/c it causes CV events

Question 13

Abuse Resistant Agonist / Antagonist

Answer 13

-suBOXone (Buprenorphine + nalOXone)

-Embeda ( Extended release morphine + naltrexone)

-OxyNal (OXYcodone + NALtrexone)