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5 Cards in this Set
- Front
- Back
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Pharmacology & Actions
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A. Narcan is a narcotic antagonist which competitively binds to narcotic sites, but has no other pharmacological action
Onset of action: 2 min Duration of action: 1-4 hours depending on dose and route of Narcan administration |
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Indications
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A. reversal of narcotic effect, particularly respiratory depression due to narcotic drugs (morphine, lomotil, propoxyphene, Darvon, Pentazocine talwin, Heroin, Codeine, Methadone
B. Diagnostically in coma of unknown etiology to rule out (or reverse) narcotic depression |
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precautions and side effects
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A. In patients physically dependent on narcotics, frank and occasionally violent withdrawl symptoms may be precipitated
B. Be prepared to restrain the patient, may become violent as the Narcan reverses the narcotic effect, titrate dose to keep patient docile C. too rapid admin = N/V dysrhythias D. abrupt reversal of narcotic depression may result in N/V sweating, tachycardia, increased BP or tremulousness |
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Admin
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STANDING ORDER
0.5-2.0mg IV push IM/SQ/IN -repeat in 2-3 minute intervals -lower doses rather then high bolus -resus = 0.5mg IV -other patients 1.0mg SQ/IM -nasal atomizer 1 cc into each nostril 2mg PEDS Standing order 0.1 mg/kg max 2mg IV, IM, IN, ET, IO bollus every 2 min |
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Special Notes
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A. This drug i remarkably safe and free from side effects, Do not hesitate to use if it indicated
B. Duration of some narcotics is longer then Narcan and the patient should be monitored closely, repeated doses of Narcan may be required C. May need larger doses to reverse Propoxyphene (Darvon) OD D. many patients can be managed with ET Tube and assisted ventilation, without narcan, you may loose airway or refusal if narcan E. septum abnormalitiesm trauma, epistaxis, excessive mucus, and mucosal destruction from other IN drugs (cocaine) may have a significant effect on rate and amount of absorption in IN meds, do not use IN in this case |
