Review Question - QID 108788

This patient is presenting with altered mental status and bradypnea which is a specific finding for an opioid overdose. Opioid overdose commonly presents with miosis.

Opioid intoxication is common and can occur secondary to illegal drugs such as heroin or prescribed drugs such as oxycodone, morphine, and hydromorphone. Patients will commonly present with somnolence, bradypnea (a specific finding), miosis, and decreased bowel sounds. If the patient is stable, the patient can "sleep off" the overdose. If for any reason the patient is unstable or is not adequately breathing, the patient should be given naloxone.

Incorrect Answers:
Answer 1: Ataxia is commonly seen in alcohol intoxication and can also be seen in Wernicke-Korsakoff syndrome which presents with ataxia, nystagmus, ophthalmoplegia, and psychosis. It is treated with thiamine.

Answer 2: Conjunctival injection is seen in marijuana intoxication which presents with slowed reaction times, inappropriate laughter, and increased appetite.

Answer 4: Mydriasis is seen in a sympathomimetic toxidrome (cocaine or amphetamines) and presents with irritability, hypertension, sweaty skin, and irritable bowel syndrome. It can also be seen in an anticholinergic toxidrome which presents with dry and flushed skin, confusion, urinary retention, and constipation.

Answer 5: Nystagmus can be seen in phencyclidine intoxication which presents with psychosis, aggressive/assaultive behavior, and severe agitation.

Bullet Summary:
Opioid intoxication presents with miosis, bradypnea, and decreased bowel sounds.