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Naloxone

Trade Names: Narcan

Class: Opioid antagonist
Pharmacology:

Onset: within 2 min
Duration: 30-60 min

Competitive narcotic antagonist. First line choice in suspected opioid OD
Indications:

Complete or partial reversal of CNS and respiratory depression induced by opioids
Narcotic agonists
Narcotic agonists/antagonists
Decreased level of consciousness
Coma of unknown origin
Opioid OD

Contraindications:

Hypersensitivity
Use w/ caution in narcotic dependent patients who may experience withdrawal symptoms
Avoid use in meperidine-induced seizures

Cautions:

Incompatible w/ bisulfite and alkaline solutions

Dosage:

Adult: 0.4 mg IV titrated until ventilation is adequate; use higher doses (up to 2 mg) for complete narcotic reversal
0.4-0.8 mg subQ/IM
Pediatric: 0.1 mg/kg IV/IO/ET every 2 min as needed IV/IO infusion: 0.002-0.16 mg/kg/hr

Side Effects:

Tachycardia
Hypertension
Dysrhythmias
Nausea and vomiting
Diaphoresis
Blurred vision
Withdrawal

Special Considerations:

Pregnancy Safety: Category C
May not reverse hypotension
Use w/ caution in narcotic addicts use smaller doses
Rare anaphylactic reactions have been reported
Seizures have been reported


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