Start naloxone with small doses, i.e. 0.04 mg, and not the standard dose of 0.4 mg IV/IM.
Drug trafficking is an international problem. Over years it has
increased in prevalence and concealment methods. Body packers swallow
wrapped packets of illicit drugs, mainly cocaine and heroin and try to
conceal them from security personnel. They present to physicians either as
body packer syndrome with symptoms of intoxication or asymptomatically
on suspicion of drug concealment, for observation.
Dose: standard is (.4mg) , but we start with( .1mg) and see the response if it
didn’t work we increase gradually till we reach .4mg.
Recently, NSOs have been involved in a significant spike of acute intoxications (classic opioid toxidrome) and overdose deaths in North America, challenging healthcare professionals, law enforcement agencies fighting against their diffusion, and policymakers trying to restrain their use
Although maternal MAT therapy is low risk to breast feeding children, opioid toxicity in young
children occurs easily via other methods. Notably, exploratory ingestions of improperly secured
medications and intentional administration of opioids by caregivers does occur.
If the patient has an opioid toxidrome, treatment with naloxone is indicated. For
agitation, tremulousness, and/or seizures, benzodiazepines are the first line
therapy. Although there are conflicting reports on naloxone to treat seizures or
naloxone causing seizures after tramadol ingestion, it is important to remember
that mechanistically, naloxone does not have any antiepileptic properties.
The opioid toxidrome includes three prominent findings - CNS depression, miosis, and
most importantly, respiratory depression - but presentations may be variable.