medic922

NARCAN prevents or reverses the effects of opioids including respiratory depression, sedation and hypotension. Also, NARCAN can reverse the psychotomimetic and dysphoric effects of agonist-antagonists such as pentazocine. NARCAN is an essentially pure opioid antagonist, i.e., it does not possess the "agonistic" or morphine-like properties characteristic of other opioid antagonists. When administered in usual doses and in the absence of opioids or agonistic effects of other opioid antagonists, it exhibits essentially no pharmacologic activity. NARCAN has not been shown to produce tolerance or cause physical or psychological dependence. In the presence of physical dependence on opioids, NARCAN will produce withdrawal symptoms. However, in the presence of opioid dependence, opiate withdrawal symptoms may appear within minutes of NARCAN administration and subside in about 2 hours. The severity and duration of the withdrawal syndrome are related to the dose of NARCAN and to the degree and type of opioid dependence. While the mechanism of action of NARCAN is not fully understood, in vitro evidence suggests that NARCAN antagonizes opioid effects by competing for the µ, [kgr ] and [sgr ] opiate receptor sites in the CNS, with the greatest affinity for the µ receptor. When NARCAN is administered intravenously (I.V.), the onset of action is generally apparent within two minutes. The onset of action is slightly less rapid when it is administered subcutaneously (S.C.) or intramuscularly (I.M.). The duration of action is dependent upon the dose and route of administration of NARCAN. Intramuscular administration produces a more prolonged effect than intravenous administration. Since the duration of action of NARCAN may be shorter than that of some opiates, the effects of the opiate may return as the effects of NARCAN dissipates. The requirement for repeat doses of NARCAN will also be dependent upon the amount, type and route of administration of the opioid being antagonized. PRECAUTIONS General In addition to NARCAN, other resuscitative measures such as maintenance of a free airway, artificial ventilation, cardiac massage, and vasopressor agents should be available and employed when necessary to counteract acute opioid poisoning. Abrupt postoperative reversal of opioid depression may result in nausea, vomiting, sweating, tremulousness, tachycardia, increased blood pressure, seizures, ventricular tachycardia and fibrillation, pulmonary edema, and cardiac arrest which may result in death. Excessive doses of NARCAN in postoperative patients may result in significant reversal of analgesia and may cause agitation (see PRECAUTIONS and DOSAGE AND ADMINISTRATION ; Usage in Adults - Postoperative Opioid Depression ). Several instances of hypotension, hypertension, ventricular tachycardia and fibrillation, pulmonary edema, and cardiac arrest have been reported in postoperative patients. Death, coma, and encephalopathy have been reported as sequelae of these events. These have occurred in patients most of whom had pre-existing cardiovascular disorders or received other drugs which may have similar adverse cardiovascular effects. Although a direct cause and effect relationship has not been established, NARCAN should be used with caution in patients with pre-existing cardiac disease or patients who have received medications with potential adverse cardiovascular effects, such as hypotension, ventricular tachycardia or fibrillation, and pulmonary edema. It has been suggested that the pathogenesis of pulmonary edema associated with the use of NARCAN is similar to neurogenic pulmonary edema, i.e., a centrally mediated massive catecholamine response leading to a dramatic shift of blood volume into the pulmonary vascular bed resulting in increased hydrostatic pressures. Drug Interactions Large doses of naloxone are required to antagonize buprenorphine since the latter has a long duration of action due to its slow rate of binding and subsequent slow dissociation from the opioid receptor. Buprenorphine antagonism is characterized by a gradual onset of the reversal effects and a decreased duration of action of the normally prolonged respiratory depression. The barbiturate methohexital appears to block the acute onset of withdrawal symptoms induced by naloxone in opiate addicts.

I have made it my own to take a BSG on all cardiac, stroke, and any pt the exhibits any weakness, dissiness (my cee button dont work lol), it has actually saved me in many instances. Even if the pt doesnt have a past Hx of diabeties. It takes only 10 seconds to check a blood sugar, might as well do it. How many of you take an oral temp.? It doesn't take long, it can tell you alot of a pt's condition. Common sense is a virtue, might as well use it.