If a patient cannot be aroused after opioid administration, what medication should be given?

• A. Naloxone
• B. Acetaminophen
• C. Ibuprofen
• D. Morphine

Answer: (A)

Opioid-induced CNS and respiratory depression requires reversing the opioid effects. Naloxone is an opioid receptor antagonist that competes with opioids at mu receptors, displacing the opioid and rapidly reversing sedation and respiratory depression. This makes it the appropriate treatment when a patient cannot be aroused after opioid administration. Be aware that if a long-acting opioid is involved, symptoms can return after naloxone wears off, so repeat dosing or an infusion may be needed and airway support should be available. The other options do not address opioid receptors: acetaminophen and ibuprofen relieve pain via different pathways and won’t reverse CNS depression, and giving more morphine would worsen the problem.