Reversal Agents

Question 1

Narcan reverses the effects of what class of medications?

Answer 1

Opioids

Question 2

Romazicon reverses the effects of what class of medications?

Answer 2

Benzodiazepines

Question 3

What is the dosage range for IV Narcan?

Answer 3

0.04-0.4 mg

Question 4

What risks are associated with acute opioid reversal?

Answer 4

1. seizures
2. V-tach and V-fib
3. pulmonary edema
4. acute opioid withdrawal (tachycardia, hypotension, diaphoresis)

Question 5

What is the typical dosage of Romazicon?

Answer 5

0.2 mg, then 0.3 mg after 30 seconds, then 0.5 mg after 1 minute, up to max total dose of 3 mg

Question 6

True or false: Romazicon should be avoided in patients that are benzodiazepine-dependent

Answer 6

True: acute withdrawal may cause seizures and ventricular dysrhythmias

Question 7

What are the side effects of Romazicon?

Answer 7

dizziness, headache, agitation

Question 8

Per Atrium policy, a patient that receives reversal by Narcan or Romazicon must remain in Phase I for monitoring for how long?

Answer 8

at least 1 hour

Question 9

Why must we monitor patients for an extended time after receiving Narcan or Romazicon?

Answer 9

The effects of the opioid/benzodiazepine can last longer than the reversal medication, and re-sedation/return of respiratory depression can occur

Question 10

What is the duration of action of Narcan?

Answer 10

30-90 minutes

Question 11

What is the duration of action of Romazicon?

Answer 11

1-2 hours