NBME 22 Naloxone (NBME Answers)

NBME 22 Answers ↦

nbme22/Block 1/Question#5 (29.2 difficulty score)
A 10-month-old girl is brought to the ...
Naloxone🔍,📺
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+2
submitted by d_holles(198),

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nwinkelmann http://medresearch.in/index.php/IJPR/article/view/782/1271 This explains a case in an infant. "Respiratory depression and coma after overdosage have been shown to be reversible by injection of naloxone [6]. Owing to its structural similarity to opioid, loperamide toxicity can be reversed by using Nalaxone which is a specific opioid antagonist acts competitively at opioid receptors. Naloxone hydrochloride is usually given intravenously for a rapid onset of action which occurs within 2 minutes." +3

yb_26 FA 2019: "Loperamide has poor CNS penetration" - so it still penetrates => can cause respiratory depression +4

whoissaad Also maybe because the blood brain barrier in a baby is not developed as well as in an adult. +4

+1
submitted by pingra(4),

I looked at it this way:

A ten month girl receiving adult doses of a mu agonist (which has POOR CNS penetration not zero) could probably have some adverse effects

I then read that the kid has a decreased RR (10/min) and marked abdominal dissension (prob due to the fact that opioids slow peristalsis; sketchy pharm also says opioids can lead to biliary colic)

Figured naloxone would reverse these symptoms

+0
submitted by syoung07(38),

Loperamide is a Mu opioid agonist that can be used to tx diarrhea. It doesn't cross the BBB so theres no chance of addiction but you can still see the effects of opioid overdose I believe. So tx opioid overdose with naloxone.

-2
submitted by dr.xx(157),

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