Opioid Toxidrome

Opioid intoxication

The goal here is to give just enough naloxone so that the patient protects their airway. The therapeutic target is thus a patient who is comfortable and sleepy, but easily awakens and protects their airway. The goal isn't to bring the patient back to a normal state of consciousness. For patients on chronic opioids, trying to “normalize” their mental status may provoke pain and severe agitation.

Narcotic or opioid toxidrome

Start naloxone with small doses, i.e. 0.04 mg, and not the standard dose of 0.4 mg IV/IM.

Opioid Overdose

Of all drugs taken in overdose, opioids have been consistently shown to be the most likely to cause death.

Opioid Toxidrome

The opioid toxidrome includes three prominent findings - CNS depression, miosis, and most importantly, respiratory depression - but presentations may be variable.

Kratom Overdoses Are on the Rise. Why They’re Hard to Spot

Its complexity means that overdose symptoms can be more difficult to diagnose — especially when compared with traditional opioids. Kratom affects the μ-receptor [mu-receptor], like other opiates, but also affects serotonin and norepinephrine reuptake inhibition.

Misuse of Novel Synthetic Opioids: A Deadly New Trend

The United States is experiencing an epidemic of opioid overdose deaths. A major factor in this crisis is the increasing availability of potent opioid drugs, including fentanyl and novel synthetic opioids (NSOs).

Mystifying Toxidrome: A Case of Heroin Body Packer Syndrome

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.

Opioids & Sedatives Toxicity

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.

The Challenge Posed by New Synthetic Opioids: Pharmacology and Toxicology

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

The ToxIC NOSE (Novel Opioid and Stimulant Exposure)

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

Tramadol revisited

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.

Emergency Management of Opioid Misuse, Overdose and Withdrawal

You might be surprised to find that just taking the first step in being part of the solution to the opioid epidemic makes these interactions become more meaningful, satisfying and impactful.

WikEM

Other than common co-ingestions, consider adulterants such as amphetamines, anticholinergics, hypnotics, heavy metals, etc. In the year after an ED visit for an opioid overdose, greater than 5% die & greater than 19% will experience another opioid overdose.