7.

Opioids

Toxicants Sign and Symptoms Mode of Toxicity Treatment

 Codeine -Bluish fingernails and lips  Ingestion  Fluids through a vein (by IV) medicine to
-Breathing problems such as slow and labored -Taking too much codeine the dose is not usually reverse the depressive effects of the
breathing not more than 360 mg per day. painkiller such as naloxone and treat other
-Constricted pupils symptoms.
-Shallow breathing  Activated charcoal (if a reversal agent is not
-No breathing given)
-Cold, clammy skin  Laxative
-Respiratory depression  Breathing support, including a tube through
the mouth and breathing machine
(ventilator)

 Methadone -Respiratory depression  Ingestion  By using Naloxone. Naloxone is a medicine

-Decreased mental status -Methadone may build up in the body to a toxic that rapidly reverses an opioid overdose. It
-Bradycardia level if it is taken too often, if the amount taken is attaches to opioid receptors and reverses and
-Hypotension too high, or if it is taken with certain other blocks the effects of other opioids. It
-Hypothermia medicines or supplements. reverses overdoses in people with opioids in
-Pinpoint pupils their systems.
-Torsades de Pointes

 Fentanyl -Decreased level of consciousness  Inhalation  Naloxone is a medication that quickly

-Slowed breathing -Causes respiratory arrest reverses the effects of opioids and can
-Lack of response to stimulation  Ingestion restore normal breathing within 2 to 3
-Constricted pupils  Through skin or eyes minutes. Naloxone can prevent death due to
-Peak respiratory depression can occur in 5 a drug overdose with fentanyl.
minutes or less  If naloxone is not available, Buprenorphine
can be used.

REFERENCES:
Codeine overdose. (n.d.). Mount Sinai Health System. https://www.mountsinai.org/health-library/poison/codeine-overdose#:~:text=Symptoms%20of%20a%20codeine%20overdose,Cold%2C%20clammy%20skin

Codeine (PIM 140). (n.d.). https://inchem.org/documents/pims/pharm/codeine.htm#SectionTitle:5.2%20Inhalation

Roberts, J. M. (2009). Clinical Toxicity of Methadone. Emergency Medicine News, 31(6), 9–12. https://doi.org/10.1097/01.eem.0000354491.91711.2d

Fentanyl: Incapacitating Agent | NIOSH | CDC. (n.d.). https://www.cdc.gov/niosh/ershdb/emergencyresponsecard_29750022.html#:~:text=Fentanyl%20depresses%20central%20nervous%20system,is%20a
%20drug%20of%20abuse.

Schiller, E. Y. (2022, September 19). Opioid Overdose. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK470415/