Emergency medical services transport an unidentified adult male to the resuscitation bay after bystanders found him comatose on a park bench. Beside him, responders noted drug paraphernalia, including a burnt spoon and an empty syringe. Initial assessment reveals marked respiratory depression with a breathing rate of 4/min, accompanied by a heart rate of 45/min. Physical examination demonstrates cyanosis of the perioral area and symmetric 1-mm pupils. Which of the following pharmacologic agents should be administered immediately?
- ANaltrexone
- BFlumazenil
- NaloxoneAnswer
- DMethadone
- ELorazepam
Answer
Naloxone
The patient's presentation of unresponsiveness, profound respiratory depression, bradycardia, and miosis (pinpoint pupils) in the setting of intravenous drug paraphernalia is highly indicative of an acute opioid overdose. The immediate life-saving intervention is the administration of naloxone, a fast-acting competitive mu-opioid receptor antagonist that rapidly reverses opioid-induced respiratory depression.
Step-by-Step Solution
Key Concept
Acute management of opioid intoxication involves the immediate administration of naloxone to reverse life-threatening respiratory depression.