Opioid Overdose

Naloxone is an opioid antagonist. It competes with opioid agonists at opioid receptors and can restore respiratory drive. The immediate treatment goal is adequate spontaneous breathing, not complete awakening, elimination of pain, or a return to the patient’s baseline behaviour. For adults and children weighing at least 12 kg: - Intranasal: 4 mg as one spray. - Intramuscular or subcutaneous: 0.4 mg as one ampoule. If there is no adequate response after 2 to 3 minutes, repeat the same dose every 2 to 3 minutes. During the first 10 minutes, the maximum cumulative dose is 8 mg intranasally—two sprays total—or 1.6 mg intramuscularly. Continue airway support and rescue breathing while waiting for the response; do not interpret the dose limit as permission to stop resuscitation or emergency escalation. Naloxone has no absolute contraindication in an overdose emergency. The risk of untreated respiratory depression outweighs the concern about precipitating withdrawal. Use caution and close observation in a pregnant or breastfeeding patient, and monitor closely if hypersensitivity to naloxone is known or suspected. Abrupt opioid reversal can produce precipitated withdrawal, particularly in...