Naloxone

Mechanism :

Naloxone hydrochloride, a narcotic antagonist, is a synthetic congener of oxymorphone. Naloxone prevents or reverses the effects of opioids including respiratory depression, sedation and hypotension. Also, it can reverse the psychotomimetic and dysphoric effects of agonist-antagonists such as pentazocine.

Indication :

Asphyxia neonatorum
Opioid induced respiratory and central depression

Contraindications :

Naloxone is contraindicated in patients known to be hypersensitive to it. Use with caution in patients dependent on opioids. Use with caution in patients with cardiac problems or those receiving cardiotoxic drugs.

Dosing :

Neonates:

0.01 mg/kg IV into umbilical vein. Subsequent dose of 0.1 mg/kg if needed.

Reversal of respiratory depression:

0.001-0.015 mg/kg/dose IV. Titrate to effect.

Adverse Effect :

Adverse effects are due to sudden reversal of narcotics may result in nausea, vomiting, increased sweating, rapid tachycardia, increased blood pressure, tremulousness, seizures and cardiac arrest. In postoperative patients, larger doses may result in reversal of analgesia and in excitement. Ventricular tachycardia and fibrillation, hypertension and pulmonary edema have been associated with the use of naloxone hydrochloride postoperatively.

Renal Dose :

Dose in Renal Impairment GFR (mL/min)

20-50	Dose as in normal renal function
10-20	Dose as in normal renal function
<10	Dose as in normal renal function

Dose in Patients undergoing Renal Replacement Therapies

CAPD	Unknown dialysability. Dose as in normal renal function
HD	Unknown dialysability. Dose as in normal renal function
HDF/High flux	Unknown dialysability. Dose as in normal renal function
CAV/VVHD	Unknown dialysability. Dose as in normal renal function

Hepatic Dose :

No dosage adjustments are recommended.