Substance
Opioids and Opiates

[Other Names]
Codeine
Dilaudid
Fentanyl
Heroin
Morphine
Methadone
Oxycodone
Oxycontin and other synthetic opioids

Pathology
Excessive stimulation of CNS opiate receptors causing sedation and respiratory failure.

Symptoms
Drowsiness, nausea, dysphoria, bradypnea, miosis, hypothermia, respiratory depression, hypotension, bradycardia, weak pulse, coma, apnea, death.

Emergency Measures
The airway should be secured and ventilatory assistance provided to comatose or apneic patients. Naloxone, naltrexone, or nalmefene can be given as an antidote. Activated charcoal may adsorb recently ingested pills.

Comments
Antidotes are useful in reversing effects of the opiates, but administration may precipitate severe withdrawal symptoms. The effects of naloxone are short-term. The drug may need to be given repeatedly or by intravenous infusion to prevent repeated episodes of respiratory depression or coma.