A 27-year-old woman with a history of intravenous heroin use is brought to the emergency department by paramedics after being found unresponsive in her apartment. Her roommate states the patient had been complaining of withdrawal symptoms earlier today. On arrival, the patient is minimally responsive to verbal stimuli. Vital signs are: heart rate 88/min, respiratory rate 8/min, blood pressure 92/58 mmHg, temperature 36.8°C. Physical examination reveals pinpoint pupils, cool and clammy skin, and scattered track marks on both upper extremities. The patient has no evidence of trauma or other acute illness. Which of the following is the most appropriate initial management?

  1. A)Administer intravenous dextrose and thiamine
  2. B)Administer intravenous lorazepam for respiratory depression
  3. C)Administer intravenous naloxoneGABARITO
  4. D)Administer intravenous haloperidol for altered mental status
  5. E)Admit to ICU for observation and supportive care alone

Explicação

Opioid overdose presents with the classic triad of respiratory depression (RR 8/min), altered consciousness (minimal responsiveness), and miosis (pinpoint pupils). Naloxone is a competitive opioid receptor antagonist that rapidly reverses opioid effects and is... Ver explicação completa e trilha adaptativa →

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