Naloxone Narcan

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GENERIC NAME: NALOXONE HCl

BRAND NAME: Narcan CLASS: Narcotic (opioid) antagonist

Mechanism of Action:

Competitive inhibition at narcotic receptor sites Reverses respiratory depression secondary to narcotics

Indications and Field Use:
Antidote for: Opioid overdoses
May differentiate opioid-induced coma from other causes

Contraindications:

Hypersensitivity

Adverse Reactions:

Withdrawal symptoms, especially in neonates (nausea, vomiting, diaphoresis, increased heart rate falling blood pressure, tremors). > Be prepared for combative patient after administration.

NOTES ON ADMINISTRATION Incompatibilities/Drug Interactions:

Should not be mixed with other drugs

Adult Dosage:

IV, IM, inject SL, SC, ET: 0.4 - 2 mg initial bolus IV or ET, may repeat every 2 minutes as necessary; titrate to effect.

Intra-nasal: 1 mg each nostril using a Mucosal Atomizer Device for a total of 2 mg. May repeat every 2 minutes as necessary. Titrate to effect.

** Continuous IV Infusion: 2/3 of the initial bolus/hr (bolus that it took to reverse) administered as a continuous infusion; i.e., if 2 mg Narcan resulted in opioid reversal initially, then it can be maintained by continuous infusion of 1.4 mg/hr. Put 1.4 mg Narcan in 250 ml NS and run at 250 ml/hr. A repeat IV bolus of twice the initial bolus administered 15 minutes after the initial bolus is recommended.

Pediatric Dosage:

< 5 years or < 20 kg: 0.1 mg/kg IV, ET, inject SL, SC, IO (includes neonate) > 5 years or > 20 kg: 0.4 - 2 mg IV, ET, inject SL, SC or IO

Routes of Administration:

IV, ET, SC, inject SL, IO or constant IV infusion

Onset of Action:

IV -- within 2 minutes

Peak Effects:

Variable

Duration of Action:

Approximately 30 - 40 minutes, may need to redose

Dosage Forms/Packaging:

0.4 mg/ml: 1 ml ampule; 1 ml, 10 ml vials 1 mg/ml: 1 ml, 2

ml ampules; 1ml, 5ml, 10 ml vials

Arizona Drug Box Supply Range:

PARAMEDIC: 10 mg

Special Notes:

> Opioid drugs include heroin, Dilaudid, morphine, meperidine, codeine, methadone, Fentanyl, Lomotil, Darvon, Darvocet, Talwin and others. Large amounts of the drug may be needed for Darvon, Darvocet, and Methadone.

> If Naloxone HCl is not available, use Nalmefene HCl (2 mg/2mL).

> For adult intra-nasal administration, 1 mg/1ml is the preferred solution. 0.4 mg/1 ml may be used as an alternative. ** Indicates special training requirement 

© Matt Dillard 2012