Page 114 - CPG - Clinical Practice Guidelines - Management of Cancer Pain
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Management of Cancer Pain (Second Edition)
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                                  GUIDE FOR NALOXONE USE

                  GENERAL PRINCIPLES:
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                     the palliative care setting when opioids are appropriately titrated
                     against the patient’s pain.
                  •   It  is  indicated  for  the  reversal of  opioid-induced  respiratory
                     depression  and not for treating drowsiness  and/or delirium
                     associated with opioids.
                  •   The dose administered should be carefully titrated against level of
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                     minute and no cyanosis).
                  •   Titration is important to  avoid acute withdrawal  syndrome and
                     severe pain.
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                     used
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                  •   Pack size: 1 ampoule = 400 mcg/1 ml
                  •   Adverse effects (usually  with large  bolus  doses): abdominal
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                     at injection site

                  TREATMENT:
                  •   Respiratory depression is  usually preceded by  a  progressive
                     reduction in consciousness.
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                     aroused  (e.g. opens eyes to verbal  command), monitor patient
                     closely and consider omitting or reducing the dose of the regular
                     opioid.
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                         injection
                     {  Administer small boluses of 0.5 ml (20 mcg) every two minutes
                         until respiratory  rate is satisfactory,  and patient is easily
                         arousable (need not be fully alert)
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                         satisfactory with multiple bolus doses.
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