NALOXONE ( NARCAN)

Duration of Action
Onset: Immediate.
Peak effect: 20 minutes.
Duration: 2 - 7 hours.
Special Considerations
Pregnancy safety: Category C.
Morphine rapidly crosses the placenta.
Safety in neonate not established.
Use with caution in geriatric population and those with COPD, asthma.
Vagotonic effect in patient with acute inferior MI (bradycardia, heart block).
Naloxone should be readily available as antidote.

Class
Narcotic antagonist
Mechanism of Action
Competitive inhibition at narcotic receptor sites.
Reverse respiratory depression secondary to depressant drugs.
Completely inhibits t effect of morphine.

Indications
Opiate overdose, coma.
Complete or partial reversal of CNS and respiratory depression induced by opioids
Narcotic agonist
Morphine, heroin, hydromorphone (Dilaudid), methadone.
Meperidine (Demerol), Paregoric, Fentanyl (Sublimase).
Oxycodone (Percodan), codeine, propoxyphene (Darvon).
Narcotic agonist and antagonist
Butorphanol (Stadol).
Pentazocine (Talwin).
Nalbuphine (Nubain).
Decreased level of consciousness.
Coma of unknown origin.
Contraindications
Use with caution in narcotic-dependent patients.
Use with caution in neonates of narcotic-addicted mothers.

Adverse Reactions
Withdrawal symptoms in the addicted patient.
Tachycardia, hypertension, dysrhythmias, nausea, vomiting, diaphoresis.
Drug Interactions
Incompatible with bisulfite and alkaline solutions.

How Supplied
0.02 mg / ml (neonate); 0.4 mg/ml, 1 mg/ml; 2.0 mg / 5 ml ampules; 2 mg/5 ml prefilled
syringe.

Dosage and Administration
Adult: 0.4 - 2.0 mg IV, IM, SC, Nasal via atomizer; min. recommended = 2.0 mg
repeat at 5 minute intervals to 10 mg maximum dose. (Medical Control may
request higher amounts). Infusion: 2 mg in 500 ml of D5W (4 mcg/ml), infuse at
0.4 mg / hr (100 ml/hour).
Pediatric: 0.1 mg / kg / dose IV, IM, SC; maximum of 0.8 mg; if no response in 10
minutes, administer an additional 0.1 mg / kg /dose.