Forensic medicine – MCQ 52 – Acute heroin intoxication

A 34-year old rickshaw puller has been using heroin for the past ten years. One evening his family members found him unconscious. He was brought to the casualty. On examination he had tachycardia, shallow breathing, constricted pupils. His blood pressure was 100/70 mm of Hg. He had brisk bilateral deep tendon reflexes. The planter reflexes were flexor on both sides. Which of the following is the best treatment for him?
A. Buprenorphine
B. Flumazenil
C. Methadone
D. Naloxone

Correct answer : D. Naloxone

The clinical features are suggestive of acute heroin intoxication. The drug of choice is naloxone – an opioid antagonist. It is reduces the action of heroin. Buprenorphine is a partial opioid agonist. Flumazenil is a benzodiazepine antagonist. Methadone is used in rehabilitation of opoid addicts.