Narcotic Antagonism

a. Explanation. As previously mentioned, narcotics depress the respiratory system. Sometimes it is necessary to reverse this respiratory depression (that is, overdose of narcotics) in order to save a patient's life.

b. Naloxone (Narcan®). Naloxone (Narcan®) is the only true narcotic antagonist in that it does not possess agonist or morphine-like properties and, most importantly, it has no respiratory depressant action in therapeutic doses. Because it does not depress respiration, naloxone is the drug of choice in the treatment of respiratory depression of unknown causes, but which is suspected of being produced by a narcotic. Narcan® is given in a usual dose of 0.4 mg IM, SC, or IV, and may produce some nausea and vomiting. It is not a controlled substance, and is available as an injection, 0.4 mg/ml or 0.2 mg/ml for pediatric use.

c. Indications/Uses. Naloxone (Narcan®) is indicated/used to reverse respiratory depression caused by natural and synthetic narcotics, pentazocine (Talwin®), and propoxyphene (Darvon®). It is not effective against the respiratory depression caused by the barbiturates or benzodiazepines. Naloxone is a competitive antagonist.

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