Naloxone

Question 1

Generic Name:

Answer 1

Naloxone HCL

Question 2

Trade Name:

Answer 2

Narcan

Question 3

Supplied:

Answer 3

2mg/2mL pre-filled syringe

Question 4

Class:

Answer 4

Narcotic (opioid) antagonist

Question 5

Mechanism of Action:

Answer 5

• Competitive inhibition at narcotic receptor sites

- Reverses respiratory depression secondary to narcotics

Question 6

Indications and Field Use:

Answer 6

• Antidote for: Opioid poisoning

- May differentiate opioid-induced coma from other causes

Question 7

Contraindications:

Answer 7

Hypersensitivity

Question 8

Adverse Reactions:

Answer 8

• Withdrawal symptoms, especially in neonates (nausea, vomiting, diaphoresis, increased heart rate, hypotension or hypertension, tremors).
• Be prepared for combative patient after administration

Question 9

Incompatibilities/Drug Interactions:

Answer 9

Should not be mixed with other drugs

Question 10

Adult Dosage: IV/IO, IM, inject SL, SC, ET:

Answer 10

2.0 mg initial bolus IV or ET, may repeat every 2 minutes as necessary; titrate to effect.

Question 11

Adult Dosage: Intra-nasal:

Answer 11

1.0 mg each nostril using a Mucosal Atomizer Device for a total of 2 mg. May repeat every 2 minutes as necessary. Titrate to effect.

Question 12

Adult Dosage: Continuous IV Infusion:

Answer 12

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 2 the initial bolus administered 15 minutes after the initial bolus is recommended.

Question 13

Pediatric Dosage: < 5 years or < 20 kg:

Answer 13

0.1 mg/kg IV, ET, inject SL, SC, IO, IN (includes neonate)

Question 14

Pediatric Dosage: > 5 years or > 20 kg:

Answer 14

2 mg IV, ET, inject SL, SC or IO, IN

Question 15

Routes of Administration:

Answer 15

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

Question 16

Onset of Action:

Answer 16

IV - within 2 minutes

Question 17

Peak Effects:

Answer 17

Variable

Question 18

Duration of Action:

Answer 18

Approximately 45 minutes

Question 19

Arizona Drug Box Minimum Supply:

Answer 19

10mg

Question 20

Special Notes:

Answer 20

•  Large amounts of the drug may be needed for oral opioid ingestion.
•  For adult intra-nasal administration, 1 mg/1ml is the preferred solution.
•  0.4 mg/1 ml may be used as an alternative.