Evidence-based management of Opioid Poisoning according to Uganda Clinical Guidelines 2023
Uganda Clinical Guidelines 2023 · all from source →
General Adult
Diagnosis
Clinical Triad
Coma. Miosis (pinpoint pupils). Respiratory depression (slow, shallow breathing).
Additional Features
Cyanosis, hypotension, bradycardia. Needle track marks (IV drug use). Reduced bowel sounds.
Treatment
Airway and Breathing
Maintain airway. Assist ventilation with oxygen. Do not leave patient unattended.
Antidote — Naloxone (HC3/HC4)
Naloxone 0.4–2 mg IV, IM, or SC. Repeat every 2–3 minutes until respiratory rate improves (max 10 mg). Child: 10 micrograms/kg IV. Note: naloxone has a short half-life; repeated doses or infusion may be needed as opioid effects outlast the antidote.
Monitoring
Monitor closely for at least 6 hours (longer if long-acting opioid, e.g., methadone). Naloxone infusion: 2/3 of the effective bolus dose per hour.
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