Voluntary or accidental overdose of opioid drugs like codeine, morphine, heroin used for therapeutic or recreational purposes.
Clinical features
- Respiratory depression
- Hypotension, hypothermia
- Pinpoint pupils
- Decreased mental status until coma
Management
Antidote:
- Naloxone 0.4-2 mg IV or IM, repeat every 2-3 minutes if not improving until max 10 mg
Child: 0.01 mg/kg, increase to 0.1 mg/kg if necessary - Aim at restoring ventilation not consciousness
- Repeated doses or infusion may be necessary
- Manage complications accordingly
Note
- Naloxone doses used in acute poisoning may not be suitable for treating opioid-induced respiratory depression and sedation in palliative care and in chronic opioid use