A 25 years old unidentified male from roadside was brought by police to emergency room with disorientation, altered sensorium and vomiting. He had a BP of 90/70 mm Hg, hea rate of 110/min, temperature -36.4degC and respiratory rate of 11/min. On examination, he had bilateral pin-point pupils. What is the most probable diagnosis?
Pontine hemorrhage
Hypothermia
Dhatura poisonine
Opioid poisoning
Ans: D. Opioid poisoning(Ref: Harrison 19/e p 1774, 2583, 18/e p3295)Findings in question represents hallmark sign of opiate overdose.Opioid overdose triad:Decreased level of consciousness + Pinpoint pupils + Respiratory depression. .Other Signs & symptoms:Hypotension, Seizures & muscle spasms.All secretions are suspended except sweat.Treatment:Specific opioid antagonist - Naloxone.Effective at reversing the cause, rather than just the symptoms, of an opioid overdose)