NARCAN (NALOXONE)
From CRS EMS Guidelines
Revision as of 21:49, 3 April 2022 by Cgabryszek (talk | contribs) (Created page with "'''Class''' Narcotic antagonist '''Pharmacology and Actions''' # Narcan is a narcotic antagonist which completely binds to narcotic receptor sites, but which exhibits almost no pharmacological activity of its own. Duration of action: 1-4 hours. '''Indications''' # Reversal of narcotic effects, particularly respiratory depression, due to narcotic drugs ingested, injected, or administered in the course of treatment. Narcotic drugs include morphine, fentanyl, meperidin...")
Class
Narcotic antagonist
Pharmacology and Actions
- Narcan is a narcotic antagonist which completely binds to narcotic receptor sites, but which exhibits almost no pharmacological activity of its own. Duration of action: 1-4 hours.
Indications
- Reversal of narcotic effects, particularly respiratory depression, due to narcotic drugs ingested, injected, or administered in the course of treatment. Narcotic drugs include morphine, fentanyl, meperidine (Demerol), heroin, hydromorphone (Dilaudid), oxycodone (Percodan, Percocet), codeine, propoxyphene (Darvon), pentazocine (Talwin).
- Diagnostically in coma or altered mental status of unknown etiology, to rule out (or reverse) narcotic respiratory depression.
- Seizures of unknown etiology, to rule out narcotic overdose (particularly propoxyphene).
Precautions
- In patients physically dependant on narcotics, frank and occasionally violent withdrawl symptoms may be precipitated. Be prepared to restrain the patient. Titrate the dose slowly to reverse cardiac and respiratory depression, but to keep the patient groggy.
- May need large doses to reverse propoxyphene (darvon) overdose.
Administration
- Adult: 0.4mg IV/IO/IN for narcotic overdose case; May repeat up to max dose of 2 mg
- If no response is observed, this dose may be repeated after 5 minutes, if narcotic overdose is strongly suspected.
- May be given through ET tube at 2 times the IV dose.
Side Effects and Special Notes
- This drug is remarkably safe and free from side effects. Do not hesitate to use if indicated.
- The duration of some narcotics is longer than narcan and the patient must be monitored closely. Repeated doses of narcan may be required. Patients who have received this drug mast be transported to the hospital because coma may reoccur when the narcan wears off.
- With an endotracheal tube in place and assisted ventilation, narcotic overdose patients may be safely managed without narcan. Think twice before totally reversing coma; airway may be lost, or (worse) the patient may become violent and may refuse transport.
