QUESTION 1
A 3-day-old preterm neonate is given morphine as post operative pain relief. They become bradycardic and apnoeic. They weigh 700 g. What dose of naloxone would you prescribe?
- Dosage is 100 micrograms/kg. 700 g converts to 0.7 kg
- 100 micrograms x 0.7 kg = 70 micrograms
QUESTION 2
A 10-month-old child weighing 8.7 kg was administered fentanyl. They become unresponsive with respiratory depression. What dose of naloxone would you prescribe?
- Dosage is 100 micrograms/kg
- 100 micrograms x 8.7 kg = 870 micrograms
QUESTION 3
An 11 year old presents with reduced consciousness, respiratory depression and bradycardia following ingestion of heroin. Their weight is estimated to be 20 kg. What dose of naloxone would you prescribe?
- Dosage is 100 micrograms/kg
- 100 x 21 = 2100 micrograms or 2.1 mg. The maximum recommended dose is 2 mg per dose
QUESTION 4
An adult with a known opioid dependency has taken an accidental overdose of methadone. They had been given intranasal naloxone in the community but present with ongoing respiratory depression. They weigh 60 kg. What dose of naloxone would you prescribe?
- Weight is irrespective of dose which is based on titrated regime
- Initial dose of 400 micrograms increasing to 800 micrograms for up to 2 doses, and final 2 mg for 1 dose
- May give 4 mg dose in seriously poisoned patients
- Consideration of route of administration to intravenous to increase bioavailability and rapid response