(3) Excessive doses may cause confusion, muscle fasciculations,
respiratory depression, coma, or convulsions.
(4)
Euphoria may occur.
e. Treatment of Overdosage. Naloxone hydrochloride (Narcan), discussed
later, is the specific antidote for propoxyphene.
f. Supply. This drug is supplied in 32 and 65 mg (Darvon) capsules and in
propoxyphene hydrochloride, aspirin, and caffeine (Darvon Compound) capsules, which
contain 389 mg of aspirin, 32 mg of propoxyphene hydrochloride, and 32.4 mg of
caffeine.
3-26. NALOXONE HYDROCHLORIDE INJECTION--NARCOTIC ANTAGONIST
a. Action and Uses. Naloxone (Narcan) is a nonagonist or complete
antagonist which will reverse most of the effects of narcotics, including respiratory
depression, without the risk of producing agonistic or morphine effects of its own. It is
indicated for the complete or partial reversal of narcotic depression, including
respiratory depression, induced by:
(1)
(2)
The narcotic-antagonist analgesic, pentazocine (Talwin).
(3)
Propoxyphene (Darvon).
NOTE: Naloxone may also be used for the diagnosis of suspected acute opiate
overdosage.
b. Administration. In an emergency, Naloxone should be administered
intravenously at a dosage of 0.01 mg/kg of body weight (about 0.8 mg) for an adult.
The onset of action of naloxone IV is within 2 to 3 minutes. This dose may be repeated
once or twice at 5-minute intervals. This drug may also be administered IM or SC.
Failure to obtain significant improvement after 2 or 3 doses suggests that the condition
may be due partly or completely to other disease processes or non-narcotic drugs. (In
the newborn, naloxone in 10 to 15 mcg/kg doses may be injected directly into the
umbilical vein, if the newborn shows evidence of narcotic-induced respiratory
depression.)
c. Cautions and Warnings.
(1) In addition to naloxone, other resuscitative measures such as
maintenance of a free airway, artificial ventilation, cardiac massage, and vasopressor
agents should be employed when necessary to counteract acute narcotic poisoning.
MD0913
3-20