Opiate Overdose

Question 1

Definition

Answer 1

Taking more opiates than you should

Question 2

Aetiology

Answer 2

· Opiates have widespread effects across the body and side-effects can range from constipation to respiratory depression and death

· Drugs involved:
o Codeine
o Diamorphine
o Dihydrocodeine
o Fentanyl
o Loperamide
o Methadone
o Morphine

Question 3

Risk factors

Answer 3

o Mental health conditions

o Alcoholics

o Morphine toxicity at a lower dose due to:
· Hepatic impairment
· Renal impairment
· Hypotension
· Hypothyroidism
· Asthma (decreased respiratory reserve)

Question 4

Epidemiology

Answer 4

· The ELDERLY are at greater risk because they are more likely to be on opiates

· Heroin and morphine are responsible for most drug-related deaths

Question 5

Presenting symptoms

Answer 5

· Constipation (if chronic)
· Nausea and vomiting
· Loss of appetite
· Sedation
· Craving the next dose
· Drowsiness (if acute overdose)

Question 6

Signs on physical examination

Answer 6

· Respiratory depression

· Hypotension and tachycardia

· Pinpoint pupils

Question 7

Investigations

Answer 7

· Toxicology screen

· Paracetamol blood level (should be considered in patients who have self-poisoned)

· If in doubt, give a small test dose of naloxone