Naloxone HCL (Narcan®)

Indications:

• Narcotic overdose
• Coma of unknown origin
• Cardiac arrest with suspected narcotic overdose etiology
• Seizure with suspected narcotic overdose etiology

Contraindications: Hypersensitivity

Precautions:

• Effective for only 30 - 60 minutes; repeat if LOC and/or respiratory status deteriorate
• Secure patient prior to administration
• Not recommended as part of initial resuscitative efforts for newborns with respiratory depression
• Avoid administration in babies whose mothers are suspected of having had long term exposure to opioids (risk of neonatal seizures)

Side Effects:

• Tachycardia
• Hypertension
• Diaphoresis
• Nausea
• Blurred vision
• Acute withdrawal syndrome (violent behavior)

With rapid administration:

• Arrhythmia
• Projectile vomiting

Adult Dose:

Standing order:
Non-cardiac arrest :

• 0.4 mg every 5 minutes slow push until the respiratory rate improves and the patient can maintain a SpO2 of 96%, OR until a total of 2 mg has been administered

Cardiac Arrest:

• 2 mg IVP/IO

Pediatric Dose:

Standing order:
Non-cardiac arrest:

• 0.1 mg/kg slow push (maximum single dose 0.4 mg) until the respiratory rate improves and the patient can maintain a SpO2 of 96%; may repeat every 2 minutes in opiate-naïve patients, OR until a total of maximum, cumulative dose of 2 mg has been administered

Cardiac Arrest

• 0.1 mg/kg IV/IO (maximum single dose: 2.0 mg)

Route:

• Intranasal (IN) rapid push
• Slow IV or IO push
• IM (alternate route)
• Subcutaneous (least preferred route)

Drug Action: Reverses narcotic effects

Class: Narcotic Antagonist

Onset: Wthin 2 minutes of IVIO administration

Duration: 30 minutes - 60 minutes