What is the first-line reversal agent for opioid overdose?

What is the first-line reversal agent for opioid overdose?

• A. Naloxone
• B. Flumazenil
• C. Naltrexone
• D. Epinephrine

Answer: (A)

Opioid toxicity causing respiratory depression is reversed most effectively by naloxone, an opioid receptor antagonist that binds strongly to mu receptors and displaces the opioids from those receptors. This rapid displacement quickly restores breathing and consciousness, making it the first-line choice in suspected opioid overdose. Because naloxone has a short duration of action, patients must be monitored and may need repeat dosing if the opioid effects outlast the antagonist, to prevent re-narcotization. Flumazenil targets benzodiazepines and is not for opioid toxicity; it can cause seizures in mixed overdoses. Naltrexone is used for long-term opioid-dependence treatment and has slower onset, unsuitable for acute reversal. Epinephrine is for life-threatening anaphylaxis or cardiac arrest, not opioid overdose.

Opioid toxicity causing respiratory depression is reversed most effectively by naloxone, an opioid receptor antagonist that binds strongly to mu receptors and displaces the opioids from those receptors. This rapid displacement quickly restores breathing and consciousness, making it the first-line choice in suspected opioid overdose. Because naloxone has a short duration of action, patients must be monitored and may need repeat dosing if the opioid effects outlast the antagonist, to prevent re-narcotization. Flumazenil targets benzodiazepines and is not for opioid toxicity; it can cause seizures in mixed overdoses. Naltrexone is used for long-term opioid-dependence treatment and has slower onset, unsuitable for acute reversal. Epinephrine is for life-threatening anaphylaxis or cardiac arrest, not opioid overdose.