OPIOID POISONING

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