The patient is hunched over in the emergency department waiting room, breathing slowly and shallowly. His wife insists he “took something”. The man has bradypnea and marked miosis. Which intoxicant does the nurse suspect?

Opioid. The signs of acute opioid intoxication are slow breathing rate (bradypnea), pupils less than 2 mm (miosis), depressed mental status, decreased lung tidal volume (shallow breaths) and decreased bowel sounds. Alcohol is also a CNS depressant, but most people with acute intoxication smell of alcohol and there will be no miosis. Cocaine intoxication causes psychomotor agitation, mydriasis (dilated pupils), tachycardia and hypertension. Methamphetamine intoxication is similar to cocaine intoxication with higher degrees of agitation and belligerence.

The patient is hunched over in the emergency department waiting r...

Category: Physiological Adaptation
Difficulty: 2

Topics: Cardiovascular Lifestyle Choices and High Risk Behavior Mental Health Disorders Neurology Assessment

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