Page 181 - 2022 Ranger Medic Handbook

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NALOXONE (NARCAN)
Class: CNS agent – narcotic (opiate) antagonist
Action: Pure opiate antagonist without agonistic (morphine-like) properties that displaces opioids at receptor sites.
Acts by completing the μ, μ, and × opiate receptor sites and forcing
Dose: 0.4–2.0mg IV, repeat q2–3min prn
Onset/Peak/Duration:
IV – Onset in 1–2 minutes/Peak in 5–15 minutes/Duration 45 minutes or longer
IM – Onset in 2–5 minutes/Peak in 5–15 minutes/Duration 45 minutes or longer
Indications: Narcotic overdose and reversal of effects of natural and synthetic narcotics (opiates), including respira-
tory depression, sedation, and hypotension; drug of choice for suspected acute opioid overdose or unknown inges-
tion with respiratory depression.
Contraindications: Hypersensitivity; pregnancy category may use during pregnancy and while breastfeeding
Adverse/Side-effects: Analgesia reversal, tremors, hyperventilation, drowsiness, sweating; increased BP, tachycar-
dia; nausea, vomiting; elevated PTT
Interactions: Reverses analgesic effects of narcotic (opiate) agonists and agonist-antagonists.
Mission Impact: GROUNDING medication for personnel on flight status. SECTION 4
K9 Dosage: 1mg (0.02–0.04mg/kg) IV/IM

NAPHAZOLINE (NAPHCON-A, VASCON, CLEAR EYES)
Class: Autonomic nervous system agent – sympathomimetic, α-adrenergic agonist, vaso constrictor, decongestant
Action: Stimulates α-adrenergic receptors in arterioles of conjunctiva and nasal mucosa to produce rapid and pro-
longed vasoconstriction, reducing fluid exudation and mucosal engorgement; systemic absorption may cause CNS
depression rather than stimulation.
Dose: 1–2gtt in each eye q6hr prn (remove contact lenses before use if worn). Limit use to 72 hours.
Indications: Ocular vasoconstriction and decongestion
Contraindications: Hypersensitivity, narrow angle glaucoma, MAOIs, hyperthyroidism, diabetes mellitus, ocular
trauma; pregnancy category may use during pregnancy and while breastfeeding
Adverse/Side-effects: Keratitis, coma, hypertension, bradycardia, blurred vision, hyperglycemia, respiratory depres-
sion, tachycardia, shock like hypotension, increased intraocular pressure, irritation, drowsiness, weakness, headache,
nausea, hypothermia, rebound congestion and chemical rhinitis with continued use
Interactions: Vasoconstrictive nasal decongestants ay reduce analgesic effect, TCAs and maprotiline may potentiate
pressor effects
Mission Impact: GROUNDING medication for personnel on flight status

2022 RANGER MEDIC HANDBOOK 167