Committee
`
`on Drugs
`
`of Administration
`and Route
`Dosage
`Naloxone
`and Children:
`Addendum
`to
`for
`Infants
`Drug Doses
`for
`Emergency
`Infants
`and Children
`
`0
`
`0
`
`the
`between
`persists
`a discrepancy
`However,
`rials.
`by the Com-
`of administration
`recommended
`routes
`necom-
`and
`the
`routes
`of
`administration
`mittee
`resuscitation
`in
`the
`AHA/AAP
`neonatal
`mended
`resuscitation
`The
`AHA/AAP
`neonatal
`guidelines.
`administered
`be
`suggest
`that
`naloxone
`guidelines
`subcutaneously,
`intramuscularly,
`intravenously,
`has
`recommended
`The
`Committee
`intratracheally.
`routes
`consist-
`and
`intratracheal
`the
`intravenous
`there
`are
`no well-controlled
`studies
`ently.
`Although
`children
`directly
`comparing
`the
`in-
`in
`infants
`and
`intratnacheal
`intramuscular
`or
`vs
`travenous
`and
`routes
`of
`administration,
`the
`Com-
`subcutaneous
`mittee’s
`recommendation
`is based
`on a concern
`that
`or
`absorption
`of
`intramuscularly
`subcutaneously
`erratic
`be
`injected
`medication
`may
`and/or
`delayed
`hypotensive,
`in
`the
`patient
`who
`is
`hypoperfused,
`and/or
`peripherally
`vasoconstnicted.
`
`or
`
`1989-1990
`Chairman
`
`ON DRUGS,
`COMMITFEE
`Ralph
`E. Kauffman,
`MD,
`William
`Banner,
`Jr, MD
`Jeffrey
`L. Blumer,
`MD
`Richard
`L. Gorman,
`MD
`George
`H. Lambert,
`MD
`Wayne
`Snodgrass,
`MD
`
`MD,
`
`PhD,
`
`American
`
`Centers
`
`for
`
`Representatives
`Liaison
`R. Bennett,
`Donald
`Association
`Medical
`Jose
`F. Cordero,
`MD, MPH,
`Disease
`Control
`Sharon
`Dooley,
`Obstetricians
`Sam A. Lucata,
`Welfare,
`Health
`Canada
`Robert
`Society
`John
`C. Petnicciani,
`Manufacturers’
`
`American
`MD,
`and Gynecologists
`MD,
`National
`Protection
`
`Peterson,
`
`MD,
`
`Canadian
`
`College
`
`of
`
`Health
`Branch,
`
`and
`
`Paediatnic
`
`Pharmaceutical
`
`MD,
`Association
`
`from
`addendum
`to
`response
`prepared
`in
`rationale
`reference
`material
`or
`of
`naloxone
`infants
`recommended
`the
`
`the
`
`Committee
`numerous
`to support
`children1
`and
`Committee
`
`for
`by
`
`on
`re-
`
`on
`
`is
`5
`
`is
`
`following
`The
`was
`Drugs
`for
`quests
`dosage
`the
`currently
`Drugs.
`of naloxone
`dose
`recommended
`currently
`The
`to
`from birth
`children
`infants
`and
`0.1 mg/kg
`for
`olden
`Children
`years
`of age
`or 20 kg of body weight.
`20
`kg
`more
`than
`than
`5 years
`of
`age
`or weighing
`may
`be
`repeated
`may
`be given
`2.0 mg.
`These
`doses
`as needed
`to maintain
`opiate
`reversal.’
`The
`higher
`dose
`recommendation
`is based,
`in part,
`on a concern
`that
`0.01
`mg/kg,
`currently
`recommended
`in
`ap-
`proved
`labeling,
`may
`not
`provide
`optimal
`opiate
`reversal
`in some
`infants.2
`In addition,
`it
`is intended
`to
`simplify
`naloxone
`dosing
`and
`provide
`greater
`probability
`of
`optimal
`opiate
`reversal
`in most
`pa-
`tients.
`Because
`administered
`felt
`that
`Naloxone
`have
`been
`Individual
`intravenous
`been
`have
`not
`verse
`effects.
`premature
`The
`has
`tion
`American
`Academy
`resuscitation”
`
`been
`have
`0.4 mg/kg
`as
`high
`as
`doses
`it
`effect,3
`without
`ill
`newborns
`to
`no
`risk.
`poses
`increased
`higher
`dose
`the
`0.005
`from
`to
`0.4 mg/kg
`doses
`ranging
`the
`pediatric
`literature.2’#{176}
`reported
`in
`0.4 mg/kg(cid:1)
`and
`constant
`doses
`to
`for
`0.16 mg/kg/h
`5 days4
`infusion
`of
`with
`naloxone-related
`ad-
`associated
`half-life
`of
`naloxone
`in
`The
`average
`newborns
`is 70 minutes.5
`recommenda-
`Committee’s
`naloxone
`dosing
`into
`the
`been
`incorporated
`recently
`(AHA)/Amenican
`Heart
`Association
`textbook
`on
`neonatal
`of Pediatrics
`(AAP)
`and
`accompanying
`test
`mate-
`
`up
`
`the
`
`joint
`
`in
`recommendations
`The
`exclusive
`course
`of treatment
`ations,
`taking
`into
`account
`appropriate.
`PEDIATRICS
`American
`
`this
`
`statement
`or procedure
`individual
`
`indicate
`not
`do
`to be followed.
`circumstances,
`
`an
`Vari-
`may
`be
`
`0031
`(ISSN
`4005).
`Academy
`of Pediatrics.
`
`Copyright
`
`© 1990
`
`by
`
`the
`
`484
`
`PEDIATRICS
`
`Vol. 86 No. 3 September
`1990
`Downloaded from
`www.aappublications.org/news
`
` by guest on January 17, 2020
`
`Nalox1207
`Nalox-1 Pharmaceuticals, LLC
`Page 1 of 4
`
`

`

`trial
`
`of
`
`poi-
`
`Ther.
`
`The
`DR
`naloxone
`
`of
`
`respiratory
`in
`
`and narcotic
`infants.
`Anesth
`
`antag-
`Anaig.
`
`Moreland
`antagonists
`
`TA, Walker
`on
`the
`
`CHM.
`newborn.
`
`Effects
`Arch
`
`of pethi-
`Child.
`Dis
`
`1977;2:228-231
`al. Clinical
`et
`V,
`J, DeBooy
`3. Chernick
`V, Manfreda
`J Pediatr.
`naloxone
`in birth
`asphyxia.
`1988;113:519-525
`infusion
`for opiate
`4. Tenebein
`M. Continuous
`naloxone
`soning
`J Pediatr.
`in infancy.
`1984;105:645-648
`pharmacokinetics
`5. Stile
`LI, Fort M, Wurburger
`RJ,
`et al. The
`of naloxone
`in the
`premature
`newborn.
`Deu Pharmacol
`1987;10:454-459
`on
`of naloxone
`P. Effects
`P, de Chateau
`6. Welles
`B, Belfrage
`newborn
`infant
`behavior
`peth-
`analgesia
`with
`after maternal
`idine
`during
`labor. Acts Obstet
`1984;63:617-.
`Gynecol
`Scand.
`619
`CG, Cook
`7. Fischer
`effects
`onistic
`1974;53:849-852
`8. Brice
`JEH,
`its
`dine
`and
`1979;54:356-361
`9. Evans
`JM, Hogg MIJ,
`sion
`the
`neonate
`1100
`E, Cohen
`T, Bancalari
`10. Gerhardt
`respiratory
`narcotic
`reverse
`to
`J Pediatr.
`1977;90:1009-1012
`infant.
`Textbook
`C, eds.
`11. Bloom
`RS, Cropley
`Dallas,
`TX: American
`Heart
`tion.
`Academy
`of Pediatrics;
`1987.
`
`in
`
`depres-
`ofnarcotic
`Rosen M. Reversal
`Br Med
`1976;2:1098-
`by
`naloxone.
`J.
`
`et
`H,
`depression
`
`of naloxone
`a!. Use
`in the
`newborn
`
`Resuscita-
`of Neonatal
`Association/American
`
`Troendle,
`Gloria
`Administration
`Sumner
`J. Yaffe,
`Child
`Health
`
`MD,
`
`Food
`
`and Drug
`
`National
`MD,
`and Human
`
`Institute
`Development
`
`of
`
`Liaison
`Section
`AAP
`M. Berlin,
`Cheston
`Pharmacology
`
`MD,
`
`Section
`
`on Clinical
`
`Consultants
`Mary
`Ellen Mortensen,
`Anthony
`R. Temple,
`
`MD
`
`MD
`
`REFERENCES
`
`of
`Academy
`1. American
`for
`drug
`doses
`Emergency
`use
`in newborns:
`clarification.
`2. Weiner
`PC, Hogg MIJ,
`Rosen
`pethidine-induced
`neonatal
`
`Pediatrics,
`infants
`
`Committee
`and
`children
`and
`1989;83:803
`Pediatrics.
`M. Effects
`of naloxone
`depression.
`Br
`Med
`
`on Drugs.
`naloxone
`
`on
`J.
`
`0
`
`0
`
`0
`
`Downloaded from
`
`AMERICAN
`ACADEMY
`OF PEDIATRICS
` by guest on January 17, 2020
`www.aappublications.org/news
`
`485
`
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`Page 2 of 4
`
`

`

`Naloxone Dosage and Route of Administration for Infants and Children: Addendum
`to Emergency Drug Doses for Infants and Children
`Committee on Drugs
`1990;86;484
`Pediatrics 
`
`Updated Information &
`Services
`
`including high resolution figures, can be found at:
`http://pediatrics.aappublications.org/content/86/3/484
`
`Permissions & Licensing
`
`Information about reproducing this article in parts (figures, tables) or in its
`entirety can be found online at:
`http://www.aappublications.org/site/misc/Permissions.xhtml
`
`Reprints
`
`Information about ordering reprints can be found online:
`http://www.aappublications.org/site/misc/reprints.xhtml
`
`Downloaded from
`
`www.aappublications.org/news
`
` by guest on January 17, 2020
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`Page 3 of 4
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`

`

`Naloxone Dosage and Route of Administration for Infants and Children: Addendum
`to Emergency Drug Doses for Infants and Children
`Committee on Drugs
`1990;86;484
`Pediatrics 
`
`The online version of this article, along with updated information and services, is located on
`the World Wide Web at:
`http://pediatrics.aappublications.org/content/86/3/484
`
`
`
`Pediatrics is the official journal of the American Academy of Pediatrics. A monthly publication, it has
`been published continuously since 1948. Pediatrics is owned, published, and trademarked by the
`American Academy of Pediatrics, 141 Northwest Point Boulevard, Elk Grove Village, Illinois, 60007.
`Copyright © 1990 by the American Academy of Pediatrics. All rights reserved. Print ISSN: 1073-0397.
`
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`
`www.aappublications.org/news
`
` by guest on January 17, 2020
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`