Question

A patient receiving morphine has an order for naloxone (Narcan) PRN. Why is the naloxone ordered? What are the indications for using this drug? Compare and contrast naloxone with other narcotic antagonists.

Answer 1

Morphine is an opiate which is given to decrease moderate to severe pain and it may cause serious or life-threatening breathing problems .It may cause withdrawal symptoms if taken for long time, patient needs to be watched closely if received morphine.

Naloxone is an antidote if morphine is overdosed. Narcan is an opioid antagonist .It blocks the effects of opioids and saves from life-threatening effects of an morphine or any opioid overdose.Naloxone will help restore breathing in a morphine overdosed patient who is experiencing respiratory depression by blocking the effects of morphine for atleast 30 - 90 minutes by decreasing shortness of breath which may otherwise lead to death.

Naloxone has no potential for abuse or dependency like morphine and other opioids

Naloxone donot cause any side effects like morphine

Noone can develop tolerance to naloxone but morphine and other opioids can lead to tolerance.

Naloxone and naltrexone are commonly used opioid antagonist drugs.

Naloxone if administered endotrachealy/IM/ SC: onset of action is within 2–5 minute and intravenously acts within 2 minutes and lasts for 20–60 minutes ,so repeated doses are often needed . Half-life is 1–1.5 hours and eliminated In urine as metabolites.

Naltrexone HCl action starts within 60 minutes if given 100 mg lasts for 48 hours, 150 mg lasts for 72 hours ,etc. Eliminated in urine as metabolites and unchanged drug.

{Ref:https://www.jpsmjournal.com/article/S0885-3924(02)00424-4/pdf}