Naloxone: Difference between revisions
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==General== | ==General== | ||
*Type: [[Opioid]] antagonists | *Type: [[Opioid]] antagonists, [[antidote]] | ||
*Dosage Forms: | *Dosage Forms: | ||
*Common Trade Names: Narcan | *Common Trade Names: Narcan | ||
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*Onset of action - 1-2min | *Onset of action - 1-2min | ||
*Duration of action - 20-90min ('''may be less than that of the ingested opioid''') | *Duration of action - 20-90min ('''may be less than that of the ingested opioid''') | ||
*For this reason many hospital algorithms call for ~3 hours of ED observation prior to discharge | |||
*Some small studies have called for decreasing this time frame to 1 hour but there are often adverse events in a significant proportion of these patients (one study showed that 15% of patients had adverse events such as need for supplemental oxygen after attempting discharge at 1 hour)<ref>Hospital Observation Upon Reversal (HOUR) With Naloxone: A Prospective Clinical Prediction Rule Validation Study Clemency, B.M., et al, Acad Emerg Med 26(1):7, January 2019</ref>. | |||
==See Also== | ==See Also== | ||
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==References== | ==References== | ||
<references/> | |||
[[Category:Pharmacology]] | [[Category:Pharmacology]] | ||
[[Category:Toxicology]] | |||
Revision as of 18:23, 20 February 2020
General
Adult Dosing
Opioid toxicity
- Bolus (May repeat q3min up to max dose 10mg
- Apneic or near-apneic - 2mg IV
- Opioid-naive with minimal respiratory depression - 0.4mg IV
- Opioid-dependent with minimal respiratory depression - 0.05mg IV
- Infusion
- Only give if the patient responded to the bolus and required repeat administration
- Step 1: Determine the "wake-up dose" or bolus required to wake the pt
- Step 2: Give 2/3 of the "wake-up dose" per hr; mix in 1L D5W
Pediatric Dosing
- IV: 0.005 to 0.01mg/kg IV every 2 to 3 minutes as needed to desired degree of reversal
- If IV route is not available, may administer in divided doses IM
Special Populations
- Pregnancy Rating: C
- Lactation: insufficient data
- Renal Dosing
- Adult
- Pediatric
- Hepatic Dosing
- Adult
- Pediatric
Contraindications
- Allergy to class/drug
Adverse Reactions
- Opioid withdrawal
- Serious complications are rare
Pharmacology
- Metabolism: hepatic
- Excretion: renal
- Mechanism of Action: opioid antagonist
- Onset of action - 1-2min
- Duration of action - 20-90min (may be less than that of the ingested opioid)
- For this reason many hospital algorithms call for ~3 hours of ED observation prior to discharge
- Some small studies have called for decreasing this time frame to 1 hour but there are often adverse events in a significant proportion of these patients (one study showed that 15% of patients had adverse events such as need for supplemental oxygen after attempting discharge at 1 hour)[1].
See Also
References
- ↑ Hospital Observation Upon Reversal (HOUR) With Naloxone: A Prospective Clinical Prediction Rule Validation Study Clemency, B.M., et al, Acad Emerg Med 26(1):7, January 2019