WHO Model Prescribing Information: Drugs Used in Anaesthesia
(1989; 60 pages) [French] View the PDF document
Table of Contents
View the documentPreface
View the documentIntroduction
Open this folder and view contentsPremedication
Open this folder and view contentsGeneral anaesthetics and oxygen
Open this folder and view contentsLocal anaesthetics
Open this folder and view contentsNon-opioid analgesics
Close this folderOpioid analgesics and antagonists
View the documentMorphine
View the documentPethidine
View the documentNaloxone
Open this folder and view contentsMuscle relaxants and cholinesterase inhibitors
Open this folder and view contentsBlood substitutes
Open this folder and view contentsSolutions for correcting water and electrolyte imbalance
Open this folder and view contentsAntacid for use in obstetric practice
View the documentAnaesthesia at the District Hospital
View the documentSelected WHO publications of related interest
View the documentBack cover
 

Naloxone

Group: opioid antagonist
Injection: 0.4 mg (hydrochloride) in 1-ml ampoule

General information

Naloxone is a semisynthetic opioid antagonist that competes with opioid analgesics for specific receptor sites in the central nervous system. Its effect, which persists for about 45 minutes, occurs within 1-2 minutes of intravenous administration.

Clinical information

Uses

To counteract respiratory depression induced by opioids administered during anaesthesia or by opioid overdosage.

Dosage and administration

Post-anaesthetic administration

Adults: 100-400 micrograms i.v. titrated to the needs of the patient and repeated, as necessary, at intervals of 2-3 minutes.

Children: 5-10 micrograms/kg i.v. repeated as above.

Neonates: 10 micrograms/kg i.v., i.m. or subcutaneously immediately after birth.

Opioid overdosage

Adults: 200 micrograms i.v. repeated, as necessary, at 2-minute intervals to a maximum of 10 mg.

Dosage should be reduced in patients with cardiovascular conditions predisposing to dysrhythmias.

Contraindications

• Known hypersensitivity to naloxone.

• Physical dependence on narcotics (naloxone will precipitate an acute withdrawal syndrome in dependent patients).

Precautions

The use of naloxone to counteract respiratory depression complements other resuscitative measures including maintenance of a clear airway, control of ventilation, cardiac massage, maintenance of an effective circulatory volume and vasopressor therapy. The necessary facilities and equipment for such treatment must be immediately available.

Use in pregnancy

Naloxone should be used during pre-term pregnancy only when the need outweighs any possible risk to the fetus.

Adverse effects

Unnecessarily high doses may cause hypertension and tachycardia. Transient nausea, vomiting, sweating, tachycardia, hypertension and tremor have been reported. Seizures are rare.

Patients with pre-existing cardiovascular disease have occasionally developed ventricular dysrhythmias.

Overdosage

Excessive dosage results in convulsions, raised blood pressure and loss of preexisting opioid analgesia.

Storage

Naloxone injection should be kept protected from light.

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