Name

naloxone (Narcan®)

Class

Synthetic opioid competitive antagonist

Description/Mechanism

Naloxone is a competitive narcotic antagonist that is used in the management and reversal of overdoses caused by narcotics and synthetic narcotic agents. Compared with other narcotic antagonists which do not completely inhibit the analgesic properties of opiates, naloxone antagonizes all actions of morphine.

Onset

Within 2 min

Duration

30-60 minutes

Indications

For the complete or partial revesral of CNS and respiratroy depression induced by opioids.

Decreased LOC

Coma of unknown origin

Contraindications

Hypersensitivity

Use with caution in narcotic-dependent patients who may experience withdrawal syndrome (including neonates of narcotic-dependent mothers)

Adverse Reactions

Tachycardia

Hypertension

Dysrhythmias

Nausea and vomiting

Diaphoresis

Drug Interactions

Incompatible with bisulfite and alkaline solutions

Supplied

0.4 mg/ml (1ml, 10 ml vials)

1 mg/ml (2 ml vials)

Dose/Administration

Adult

IV/IM: 2 mg, may repeat at 5 minute intervals up to a max of 10 mg titrated to increased respiratory effort.

Infusion: 8 mg in 1000ml at 0.8 mg/hr

Pediatric

IV/IM: 0.01 mg/kg titrated to increased respirtory effort up to a max of 10 mg.

Special Consideration

Pregnancy Safety: Category B

Seizures have been reported (no causal relationship established)

May not reverse hypotension

Caution should be exercised when administering naloxone to narcotic addicts (may precipitate withdrawal syndrome with hypertension, tachycardia and violent behavior)