Opioid poisoning

• Treatment is supportive with attention particularly to respiratory depression and cardiovascular disturbance.

• Naloxone may be used as an antidote (0.2-0.4mg IV) although rapid reversal is not desired in abusers.

• Naloxone is short acting so reversal may be temporary.

• Consider HIV infection and endocarditis in IV drug abusers.

• In iatrogenic poisoning naloxone will reverse the pain relief that opioids were given for. In these cases respiratory depression is better reversed by the non-specific respiratory stimulant doxapram (1.0-1.5mg/kg over 30s IV followed by 1.5-4.0mg/mi n).

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