MEDizzy - A 23-year-old known heroin addict is brought to the

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Chemotherapy and toxicology

A 23-year-old known heroin addict is brought to the emergency room for unresponsiveness. On examination, he is found to have pin-point pupils and respiratory depression. His fingerstick glucose measurement is normal. What is the most appropriate agent to administer at this point?

ExplanationGiven the patient’s history and clinical findings, he is likely to be expe- riencing opioid overdose. The drug of choice in such a scenario is naloxone, an opioid- receptor antagonist. Insulin is used to treat hyperglycemia, which is less likely to cause altered mental status than is hypoglycemia. Dimercaprol is a chelator used in many cases of heavy metal toxicity (i.e., lead). Penicillamine is used in the treatment of copper toxicity, as in Wilson’s disease. Atropine is used to treat cholinergic toxicity, which can cause miosis, although an unlikely cause in this clinical presentation.