Naloxone (Narcan)

CHEMICAL NAME n-Allylnoroxymorphone

GENERIC NAME Naloxone

TRADE NAME Evzio [DSC], Kloxxado, LifEMS Naloxone [DSC], Narcan, Zimhi

CLASSIFICATION Antidote, Specific Opioid Antagonist

MECHANISM OF ACTION

Naloxone’s mechanism of action is that it competitively binds and displaces opioid molecules, to
reverse the effects of opioids. It does this by attaching to mu, kappa, and gamma opioid
receptors in the CNS. When the molecules attach to these receptors it reverses effects such as
analgesia, euphoria, sedation, miosis, and most importantly bradycardia, respiratory depression,
and physical dependence.

THERAPEUTIC USES

Because of its ability to displace opioid molecules that are already attached to receptors, Narcan is used as
an antidote for opioid overdoses. It’s also used in cases where overdose in not confirmed but suspected. A
use that is considered off label is for the treatment and management of opioid addiction. Most
interestingly it is used by military personnel and chemical incident responders who are entering areas
where opioids have contaminated the air supply or are used as chemical weapons.

ADVERSE EFFECTS
Naloxone has many effects on all systems of the body. In the cardiovascular system its effects include
flushing, hypertension, hypotension, presyncope, tachycardia, ventricular fibrillation and ventricular
tachycardia. At the dermatologic level it can cause diaphoresis, piloerection, xeroderma, and erythema
locally at the sight of injection. Gastrointestinal side effects include abdominal cramps, abdominal pain,
constipation, diarrhea, nausea, toothache, and vomiting. It also causes hot flashes stemming from the
endocrine and metabolic system, and increased serum bilirubin in the hepatic system. The most notable
symptoms arise from the nervous system including agitation, body pain, coma, confusion, disorientation,
dizziness, encephalopathy, excessive crying, hallucination, headache, hyperreflexia, irritability,
nervousness, paresthesia, restlessness, seizure, shivering, tonic-clonic epilepsy, withdrawal syndrome,
and yawning. Symptoms of the neuromuscular system present as asthenia, muscle spasm, muscular pain,
and tremors. Effects on the respiratory system include dry nose, dyspnea, hypoxia, nasal congestion, nasal
discomfort, nasal mucosa swelling, pulmonary edema, respiratory depression, rhinitis, rhinorrhea and
sneezing.

DENTAL CONSIDERATIONS

Naloxone can cause many unfortunate effects on dental treatment. Not only does Naloxone
cause tooth decay and cavities, but it can also precipitate oral infections and tooth loss. Tooth
loss most commonly occurs when taking the sublingual tablet, or buccal film form of the
medication.

COMMENTS

All and all I think Naloxone is an incredibly useful drug. It not only has the power to save people’s lives
but also helps them in recovering from addiction. In doing this research one of the things I learned is that
in most states Naloxone is available without a prescription with 40% of people having zero copay. Some
states even have organizations that will give it away for free. I think this is a great way to reduce deaths
from opioid overdose. It also must be such a relief for family and friends of drug addicts who live in a
constant state of worry when their loved ones are using.

REFERENCES
- What is NARCAN® (naloxone) Nasal Spray. (2018). Narcan.com.

https://www.narcan.com/

- ‌Login. (n.d.). Online.lexi.com. Retrieved May 5, 2022, from

https://online.lexi.com/lco/action/doc/retrieve/docid/dental_f/46162?

cesid=6vvyeQ05Eom&searchUrl=%2Flco%2Faction%2Fsearch%3Fq%3DNaloxone%26t

%3Dname%26va%3DNaloxone#vap

- PubChem. (2019). Naloxone. Nih.gov; PubChem.

https://pubchem.ncbi.nlm.nih.gov/compound/naloxone

- Pickett, F. A., & Terézhalmy, G. T. (2009). Basic principles of pharmacology with dental

hygiene applications. Philadelphia, Pa. [U.A.] Wolters Kluwer Lippincott Williams &

Wilkins.