Narcotic (morphine, heroin) overdose

Description A life threatening ...

Description

A life threatening condition where too much narcotic is taken resulting in decreased breathing and if untreated death. Loss of normal swallowing reflexes can occur; and if the patient vomits the stomach contents can enter the lungs. This is called aspiration and can result in a serious lung infection called aspiration pneumonia. A heart attack or stroke can occur because depressed breathing decreases oxygen supply to the heart and brain.

Symptoms

Confusion, coma, vomiting, poor or no respiratory effort, blue skin (cyanosis), weak pulse.

Tests

Common tests used for diagnosis and treatment

Workup:
A history and physical exam will be performed. Tests include an electrocardiogram (ECG) to look for heart rhythm abnormalities, chest x-ray to look for aspiration pneumonia and blood tests to look for electrolyte abnormalities and liver and kidney malfunction.

Tests:
Pregnancy (BHCG) test, Complete blood count (CBC), Comprehensive metabolic panel (CMP), CT Scan, Electrocardiogram (EKG), Troponin, Urinalysis (UA), X-ray

Other Specific Tests: Urine or serum toxicology screen

Specialists:
Emergency Medicine, Medical Toxicology

Treatment

These patients need immediate treatment to prevent permanent brain damage and death. A narcotic antagonist is administered, most commonly naloxone (Narcan). Naloxone can be given in the vein (intravenous), in the muscle (intramuscular / IM), under the skin (subcutaneously) or down a breathing tube (endotracheal tube). It has a rapid onset of action. If the patient is a chronic user of narcotics he/she will experience acute narcotic withdrawal upon administering of the drug. The other deleterious effects of the overdose will be treated as well.