A 76-year-old male with back problems is unresponsive and only responds to painful stimuli; pale, diaphoretic; vitals show P 56, R 6, shallow respirations, with constricted pupils. What medication should you administer?

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Multiple Choice

A 76-year-old male with back problems is unresponsive and only responds to painful stimuli; pale, diaphoretic; vitals show P 56, R 6, shallow respirations, with constricted pupils. What medication should you administer?

Recognize opioid overdose. The combination of unresponsiveness, minimal response to painful stimuli, slowed and shallow breathing, bradycardia, pale skin, sweating, and pinpoint pupils fits opioid toxicity. Naloxone is the antagonist that reverses opioid effects by displacing opioids from μ-opioid receptors, rapidly restoring respiration and consciousness. It acts quickly when given by intranasal, IM, or IV routes and is the first-line treatment in suspected opioid overdose in the prehospital setting. The other choices don’t address the underlying problem here. Epinephrine would be used for life-threatening allergic reactions or certain cardiac arrest scenarios, not to reverse opioid-induced respiratory depression. Glucagon is used for hypoglycemia and can be considered in some overdose situations, but not for opioid toxicity. Aspirin is indicated for pain, fever, or suspected certain toxic ingestions, and would not reverse respiratory depression or consciousness in this scenario.

Recognize opioid overdose. The combination of unresponsiveness, minimal response to painful stimuli, slowed and shallow breathing, bradycardia, pale skin, sweating, and pinpoint pupils fits opioid toxicity. Naloxone is the antagonist that reverses opioid effects by displacing opioids from μ-opioid receptors, rapidly restoring respiration and consciousness. It acts quickly when given by intranasal, IM, or IV routes and is the first-line treatment in suspected opioid overdose in the prehospital setting.

The other choices don’t address the underlying problem here. Epinephrine would be used for life-threatening allergic reactions or certain cardiac arrest scenarios, not to reverse opioid-induced respiratory depression. Glucagon is used for hypoglycemia and can be considered in some overdose situations, but not for opioid toxicity. Aspirin is indicated for pain, fever, or suspected certain toxic ingestions, and would not reverse respiratory depression or consciousness in this scenario.

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