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Opioid toxicity — SCE Acute Medicine MCQ

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EasyToxicology and OverdoseOpioid toxicitySCE Acute Medicine

A 36-year-old man is assessed on the acute medical unit. He is found drowsy with pinpoint pupils, respiratory rate 6/min and oxygen saturation 84%. Friends report heroin use. Initial assessment includes relevant observations, bedside tests and urgent blood results. What is the most appropriate next step in management?

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Correct answer: D — Give titrated intravenous naloxone with airway support

Give titrated intravenous naloxone with airway support is the best answer because opioid toxicity with respiratory depression requires airway support and titrated naloxone. Arrange urgent CT imaging before treatment is plausible, but it is less appropriate for the physiology or timing described in this stem. The other distractors either fit a neighbouring presentation, delay definitive treatment, or miss the key immediate risk. Clinical pearl: Naloxone duration may be shorter than the opioid, so recurrent toxicity must be anticipated.

Reference: Toxbase; BNF