Acute & emergency · UKMLA & AKT
Opioid overdose
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise opioid overdose — the full SA Note notes add investigations, management, complications and 10 practice questions.
Key high-yield points
- The opioid toxidrome is one of the most recognisable patterns in emergency medicine - rapid recognition is life-saving.
- Classic triad: pinpoint pupils (miosis), reduced/absent consciousness, respiratory depression
- Miosis - 1-2 mm, symmetrical; near-pathognomonic; enhanced parasympathetic tone via mu receptor activation
- Respiratory depression - reduced rate (<12 breaths/min) and/or tidal volume; can progress to apnoea; the life-threatening feature
- Reduced consciousness - drowsiness to coma
- Bradycardia, hypotension, hypothermia, decreased bowel sounds - additional features
- Cyanosis/desaturation - late sign of significant hypoventilation
If pupils are dilated - consider co-ingestion of a sympathomimetic. If pupils are asymmetrical - consider a structural intracranial cause (not opioid toxicity).
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