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Nursing QUESTION #9271
Question 1
A 2-year-old child accidentally ingests an unknown household substance and is brought to the emergency. The child is drowsy, has pinpoint pupils, and respiratory rate of 6/min. The MOST appropriate antidote is:
  • Atropine IV
  • Naloxone 0.1 mg/kg IV/IM✔️
  • N-Acetylcysteine
  • Flumazenil
Correct Answer Explanation

The clinical triad of pinpoint pupils (miosis) + drowsiness/coma + respiratory depression is the classic presentation of Opioid Poisoning.

Opioid toxidrome:

  • CNS depression (lethargy → coma)
  • Respiratory depression (RR <12/min — most dangerous)
  • Miosis (pinpoint pupils)
  • Bradycardia, hypotension

Antidote: Naloxone (Narcan) — opioid receptor antagonist

\[\text{Dose: } 0.1\,\text{mg/kg}\,\text{IV/IM/intranasal (max 2 mg per dose)}\]

  • Onset IV: 1–2 minutes
  • Duration: 30–90 minutes (shorter than most opioids — may need repeat doses or infusion)
  • Monitor for re-narcotization

Other antidotes (important for nurses):

PoisonAntidote
OrganophosphatesAtropine + Pralidoxime
ParacetamolN-Acetylcysteine
BenzodiazepinesFlumazenil
IronDesferrioxamine
LeadDMSA (Succimer), EDTA
Carbon monoxide100% O₂ / Hyperbaric O₂