| Name: |
NALOXONE (NarcanR) |
| Classification: |
narcotic antagonist
- used in the reversal of narcotic induced respiratory depression
- has no analgesic properties
- used for reversal of respiratory depression during epidural narcotic administration
- low dose naloxone can decrease pruritis associated with epidural narcotic administration
|
| Dose: |
- Bolus:
- 0.1 - 0.2mg IV direct
- produces partial reversal of post-operative narcotic depression
- doses given at 2-3 minute intervals until desired degree of reversal is achieved (ie. adequate ventilation and alertness without significant pain)
- Treatment of known opiate overdose or to aid in the diagnosis of suspected overdose:
- Maintenance Infusions:
- loading dose: 0.4mg
- 0.1 - 0.4mg/h
- rate of administration titrated to the patient effect
- useful in patients requiring high doses or prolonged therapy
|
| Administration: |
IV Infusion:
2mg/500mL NS or D5W
- infusion concurrent with epidural narcotics: 0.8mg/L
- prepared infusion solutions do not need to be protected from light
|
| Adverse Effects: |
- hypertension or hypotension
- ventricular ectopic rhythms
- pulmonary edema (most common in post-operative patients with pre-existing cardiac disease, hypertension and patients receiving B2 agonist therapy)
- nausea, vomiting, sweating: secondary to abrupt cessation/reversal of narcotic
- tremors
- hyperventilation or respiratory depression
- in respiratory depression that is reversed with naloxone, monitor closely for rebound respiratory depression
|
| Caution: |
- in patients with myocardial ischemia as rapid withdrawal of narcotic may result in hypertension and myocardial ischemia
|
| Drug Interactions: |
- naloxone + captopril = decreased captopril effect
|
| Monitoring Therapy: |
- duration of action of some narcotics may exceed that of naloxone; patient should be observed continuously for respiratory depression and doses repeated as required
- HR, ECG
- BP
- respiratory rate and rhythm
- analgesic response
|
| CCTC Protocol: |
- May be administered IV direct or by IV infusion by an approved nurse in CCTC.
|
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