A 20-year-old man is brought to the emergency department by his mother 20 minutes after being discovered unconscious at home. On arrival, he is unresponsive to painful stimuli. His pulse is 65/min, respirations are 8/min, and blood pressure is 110/70 mm Hg. Pulse oximetry shows an oxygen saturation of 75%. There was an empty bottle of hydrocodone-acetaminophen next to him, but she does not know how many pills were in it. A1 dose of intravenous naloxone is administered, and his vital signs, including respirations, are improved. One hour later, he has worsening lethargy, bradypnea, and miosis. Which of the following most likely accounts for this patient's current clinical deterioration?

Question

A 20-year-old man is brought to the emergency department by his mother 20 minutes after being discovered unconscious at home. On arrival, he is unresponsive to painful stimuli. His pulse is 65/min, respirations are 8/min, and blood pressure is 110/70 mm Hg. Pulse oximetry shows an oxygen saturation of 75%.   There was an empty bottle of hydrocodone-acetaminophen next to him, but she does not know how many pills were in it. A1 dose of intravenous naloxone is administered, and his  vital signs, including respirations, are improved.  One hour later, he has worsening lethargy, bradypnea, and miosis.  Which of the following most likely accounts for this patient's current clinical deterioration?

Quizplus · Accepted Answer

Eductional Objective: Naloxone is a short-acting opioid antagonist used for the treatment of opioid overdose (eg, respiratory depression, decreased level of consciousness, miosis, decreased bowel sounds).  Naloxone frequently requires redosing to prevent recurrent overdose symptoms due to its short half-life (<1 hr).

A 20-Year-Old Man Is Brought to the Emergency Department by His