You have just administered 25 g of D50 to a 45-year-old female with a history of diabetes and a BGL of 15 mg/dL. Five minutes later her BGL is 180 mg/dL, but she remains unresponsive. Vitals: BP 200/100, P 110, R 20. What should you administer?

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Multiple Choice

You have just administered 25 g of D50 to a 45-year-old female with a history of diabetes and a BGL of 15 mg/dL. Five minutes later her BGL is 180 mg/dL, but she remains unresponsive. Vitals: BP 200/100, P 110, R 20. What should you administer?

When glucose isn’t the problem anymore, the unresponsiveness points to a central nervous system depressant, most commonly an opioid. Naloxone is the antidote for opioid overdose because it binds to opioid receptors and reverses the sedative and respiratory effects of opioids. Since you’ve already given dextrose and the blood glucose is now normal, giving more glucose won’t help this situation. Administering naloxone to reverse the opioid effects is the most appropriate next step. A typical starting dose is 2 mg IV, with repeat dosing as needed while you monitor breathing and airway. Be ready to support ventilation and watch for withdrawal symptoms or re-narcotization if longer-acting opioids are involved. The other options don’t address opioid-induced depression: dextrose won’t fix the current unresponsiveness once glucose is corrected, while morphine would worsen sedation and epinephrine isn’t the indicated reversal for opioid overdose.

When glucose isn’t the problem anymore, the unresponsiveness points to a central nervous system depressant, most commonly an opioid. Naloxone is the antidote for opioid overdose because it binds to opioid receptors and reverses the sedative and respiratory effects of opioids. Since you’ve already given dextrose and the blood glucose is now normal, giving more glucose won’t help this situation. Administering naloxone to reverse the opioid effects is the most appropriate next step. A typical starting dose is 2 mg IV, with repeat dosing as needed while you monitor breathing and airway. Be ready to support ventilation and watch for withdrawal symptoms or re-narcotization if longer-acting opioids are involved. The other options don’t address opioid-induced depression: dextrose won’t fix the current unresponsiveness once glucose is corrected, while morphine would worsen sedation and epinephrine isn’t the indicated reversal for opioid overdose.

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