Dx based on pin-point pupils, respiratory depression, drowsiness or coma
Pupils may be dilated if the patient is hypothermic, hypotensive (e.g. secondary to opioids), hypoxic
Convulsions and pulmonary oedema may develop
Therapeutic trail of Naloxone (short-acting and repeated doses/infusion required)
Naloxone can be delivered Intra-nasally, as a Nebuliser or IM
Nebulised is an option when the patient is relatively stable (as long as the patient had some spontaneous respiratory effort and no severe cardiorespiratory compromise. (Ref))
Naloxone should only be given IV in cases requiring multiple doses of Naloxone (e.g. methadone OD). Start an IV Naloxone infusion at 1/3 the first hours requirements per hour
Naloxone
Intra-nasally
2 mg (2 ml) of Naloxone and attach nasal atomizer (details)
Nebulised
Nebulised - 2 mg of Naloxone with 3 mL of normal saline
Intramuscular
0.4mg aliquots up to 2mg
IV infusion
Start an IV Naloxone infusion at 1/3 the first hours requirements per hour