ATHIOL

*Overdosage with opioids:* BY IV INJ, OR BY SC INJ, OR BY IM INJ: Adult & Children above 12 yrs: Initially 400 mcg, then 800 mcg for up to 2 doses at 1 minute intervals if no response to preceding dose, then increased to 2 mg for 1 dose if still no response (4 mg dose may be required in seriously poisoned patients), then review diagnosis; further doses may be required if respiratory function deteriorates. Children 1 month-11 yrs: Initially 100 mcg/kg, if no response, repeat at intervals of 1 minute to a total max. 2 mg, then review diagnosis; further doses may be required if respiratory function deteriorates. BY CONTINUOUS IV INF: Adult & Children: Using an INF pump, adjust rate according to response; initially, rate may be set at 60% of the initial resuscitative IV injection dose per hour, a dose is that maintained satisfactory ventilation for at least 15 minutes. *Overdosage with opioids in a non-medical setting:* BY IM INJ: Adult: 400 mcg every 2-3 minutes, each dose given in subsequent resuscitation cycles if patient not breathing normally, continue until consciousness regained, breathing normally, medical assistance available, or contents of syringe used up; to be injected into deltoid region or anterolateral thigh. *Reversal of postoperative respiratory depression:* BY IV INJ: Adult & Children above 12 yrs: Initially 100-200 mcg, alternatively (by IV injection) initially 1.5-3 mcg/kg, if response inadequate, give subsequent doses, (by IV injection) 100 mcg every 2 minutes, alternatively (by IM injection) 100 mcg every 1-2 hours. Children 1 month-11 yrs: 1 mcg/kg, repeated every 2-3 minutes if required.

To be administered by IV, IM or SC injection. The most rapid onset of action is achieved with IV use, which is recommended in emergency situations. Titrate the administration rate in accordance with the patients response. Dilute in NS or D5W solutions. The addition of 2 mg in 500 ml of either solution provides a concentration of 0.004 mg/ml.

Cardiovascular disease or those receiving cardiotoxic drugs (risk of serious adverse cardiovascular effects), maternal physical dependence on opioids (may precipitate withdrawal in newborn), pain, physical dependence on opioids (precipitates withdrawal), pregnancy except in labour, keep patient under observation as repeat doses may be needed.

Agitation, cardiac arrest, headache, dizziness, dyspnoea (in children), hypertension, hyperventilation, hypotension, nausea, pulmonary oedema, tachycardia, ventricular fibrillation, vomiting, arrhythmia, bradycardia, diarrhoea, dry mouth, excitement, hyperventilation, paraesthesia, sweating, tremor. Rare: Seizures, anaphylaxis