A laboring woman received meperidine (Demerol) IV 90 minutes before she gave birth. Which of the following medications should be available to decrease the postnatal effects of meperidine on the neonate?
1. Fentanyl (Sublimaze)
2. Promethazine (Phenergan)
3. Naloxone (Narcan)
4. Nalbuphine (Nubain)
3
1, 2, 4. Incorrect. These medications do not act as opioid antagonists to decrease the postnatal effects of meperidine on the neonate.
3. Correct. An opioid antagonist can be given to the newborn as one part of the treatment for neonatal narcosis, which is a state of CNS depression in the newborn produced by an opioid. Opioid antagonists such as naloxone can promptly reverse the CNS depressant effects, especially respiratory depressions.
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